Posters— Medical Oncology

METASTATIC ANGIOSARCOMA – RECENT TREATMENT RESULTS

Harmon DC (Massachusetts General Hospital, Boston, MA 02114)

Metastatic angiosarcoma is often viewed as an unfavorable form of sarcoma. We were surprised to find 2 long-term remissions among patients treated aggressively as well as a string of responders to milder chemotherapy, so we reviewed the charts of all patients evaluated at MGH in the past 8 years. Of 20 patients seen in consultation for metastatic angiosarcoma 4 declined any therapy, primarily because of older age or complicating medical illnesses. 2 patients were treated elsewhere and follow-up is not available. The 14 remaining patients had 17 courses of treatment. There were 11 major responses, 7 that were complete or near-complete, with 2 possible cures. One patient treated with carboplatinum/taxol for undifferentiated tumor got a 4-month near-CR before dying of toxicity shortly after pathology review at MGH showed angiosarcoma. Of 10 patients who received MAID chemotherapy (mesna, doxorubicin, ifosfamide, dacarbazine), 3 had CR’s (complete responses) including 2 continuous remissions of over 6 years. One of these long-term survivors was treated with radiation to his partially resected maxillary sinus primary and consolidated with MAID and a carboplatin/cyclophosphamide stem cell transplant after resection of a lymph node metastasis. The other survivor had 2 brain metastases resected at diagnosis, then radiation to a hard-to-diagnose scalp primary, then MAID for lymph node metastases. The 3rd CR lasted only 4 months after MAID alone, but another patient with a PR (partial response) to MAID alone at 5+ months is approaching CR. Another patient, who got MAID followed by stem cell transplant, relapsed and then got a 1-year near-CR to single-agent vinorelbine, relapsed and got a 2^nd 1-year near-CR to vinorelbine. Thereafter, one patient, who had no response to MAID, got a 5-month PR to vinorelbine. 3 patients too old to get MAID received vinorelbine alone instead, and 1 got a near-CR of 6+ months and 2 had PR’s of 13 and 7+ months. Aggressive multi-agent, multi-modality treatment for those who can tolerate it and milder single-agent vinorelbine for those who cannot may be an appropriate policy for dealing with metastatic angiosarcoma.