Concurrent paclitaxel and radiation therapy for the treatment of cutaneous angiosarcoma

Amit Roy; Prashant Gabani; Elizabeth J Davis; Peter Oppelt; Emily Merfeld; Vicky L Keedy; Imran Zoberi; John S A Chrisinger; Jeff M Michalski; Brian Van Tine; Matthew B Spraker

doi:10.1016/j.ctro.2021.01.009

Concurrent paclitaxel and radiation therapy for the treatment of cutaneous angiosarcoma

Clin Transl Radiat Oncol. 2021 Jan 28:27:114-120. doi: 10.1016/j.ctro.2021.01.009. eCollection 2021 Mar.

Authors

Affiliations

¹ Department of Radiation Oncology, Washington University School of Medicine, 4921 Parkview Place, St. Louis, MO 63110, United States.
² Baylor Scott and White Health Cancer Center, 300 University Blvd., Bldg. A, Round Rock, TX 78665, United States.
³ Department of Hematology and Oncology, Vanderbilt University School of Medicine, 1161 21st Ave S # D3300, Nashville, TN 37232, United States.
⁴ Division of Medical Oncology, Washington University School of Medicine, 4921 Parkview Place, St. Louis, MO 63110, United States.
⁵ Department of Human Oncology, University of Wisconsin School of Medicine, 600 Highland Ave, Madison, WI 53792, United States.
⁶ Department of Pathology and Immunology, Washington University School of Medicine, 4921 Parkview Place, St. Louis, MO 63110, United States.

Abstract

Introduction: We compared clinical outcomes in patients with cutaneous angiosarcoma receiving concurrent paclitaxel-based chemoradiotherapy (CRT) vs. other modalities (Non-CRT).

Materials and methods: Patients with non-metastatic cutaneous angiosarcoma diagnosed from 1998 to 2018 at two institutions were identified. In the CRT cohort, paclitaxel 80 mg/m² weekly was given for up to 12 weeks and patients received radiotherapy (RT) during the final 6 weeks of chemotherapy. The RT dose was 50-50.4 Gy delivered in 1.8-2 Gy per fraction with an optional post-operative boost of 10-16 Gy. Kaplan-Meier and log-rank statistics were used to compare the outcomes between the two groups. P < 0.05 was considered statistically significant.

Results: Fifty-seven patients were included: 22 CRT and 35 Non-CRT. The CRT cohort had more patients > 60 years (100% vs. 60%, p < 0.001) and tumors >5 cm (68.2% vs 54.3%, p = 0.023). The median follow-up was 25.8 (1.5-155.2) months. There was no significant difference in 2-year local control (LC), distant control (DC), or progression-free survival (PFS) between the two groups. The 2-year overall survival (OS) was significantly higher for the CRT cohort (94.1% vs. 71.6%, p = 0.033). Amongst the subset of patients in the CRT cohort who received trimodality therapy, the 2-year LC, DC, PFS, and OS was 68.6%, 100%, 68.6%, and 100%, respectively.

Conclusion: The use of concurrent paclitaxel CRT demonstrates promising outcomes. Given these results, we are currently evaluating the safety and efficacy of this regimen in prospective, phase 2 trial (NCT03921008).

Keywords: Angiosarcoma; CRT, paclitaxel-based chemoradiation; Chemotherapy; Concurrent chemoradiation; DC, distant control; LC, local control; Non-CRT, other modalities; OS, overall survival; PFS, progression-free survival; Paclitaxel; RT, radiotherapy; Radiation therapy.

Associated data

ClinicalTrials.gov/NCT03921008