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The Value of Anti-Angiogenics in Soft Tissue Sarcoma Therapy

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Tumor Angiogenesis
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Abstract

Soft tissue sarcomas are a rare and diverse group of tumors of mesenchymal origin with a spectrum of differing behaviors. While surgery is the mainstay of treatment in localized disease, a large proportion may metastasize. In the metastatic or advanced disease setting, cytotoxic chemotherapy is of modest benefit and there is a clear need for new treatments. Emerging preclinical data have shown that angiogenesis is a credible target in soft tissue sarcomas. Early clinical trials and retrospective case studies have shown that a number of anti-angiogenic agents have evidence of benefit. One drug, pazopanib, has recently been approved for the treatment of patients with advanced soft tissue sarcomas. However, a lot still has to be gained in understanding of biological markers of response and correct selection of histological subtypes.

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References

  • Agulnik M, Yarber JL, Okuno SH et al (2013) An open-label multicentre, phase II study of bevacizumab for the treatment of angiosarcoma and epithelioid haemangioendotheliomas. Ann Oncol 24(1):257–263

    Article  CAS  PubMed  Google Scholar 

  • Antonescu CR, Yoshida A, Guo T et al (2009) KDR activating mutations in human angiosarcomas are sensitive to specific kinase inhibitors. Cancer Res 69(18):7175–7179

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Attia S, Okuno SH, Robinson SI et al (2015) Clinical activity of pazopanib in metastatic extraosseous ewing sarcoma. Rare Tumours 7(2):5992

    Google Scholar 

  • Azizi AA, Haberler C, Czech T et al (2006) Vascular- endothelial-growth-factor (VEGF) expression and possible response to angiogenesis inhibitor bevacizumab in metastatic alveolar soft part sarcoma. Lancet Oncol 7(6):521–523

    Article  PubMed  Google Scholar 

  • Belotti D, Vergani V, Drudis T et al (1996) The microtubule–affecting drug paclitaxel has antiangiogenic activity. Clin Cancer Res 2:1843–1849

    CAS  PubMed  Google Scholar 

  • Chao C, Al-Saleem T, Brooks JJ et al (2001) Vascular endothelial growth factor and soft tissue sarcomas: tumour expression correlates with grade. Ann Surg Oncol 8(3):260–267

    Article  CAS  PubMed  Google Scholar 

  • Choi H, Charnsangavej C, Faria SC et al (2007) Correlation of computed tomography and positron emission tomography in patients with metastatic gastrointestinal stromal tumor treated at a single institution with imatinib mesylate: proposal of new computed tomography response criteria. J Clin Oncol 25(13):1753–1759

    Article  PubMed  Google Scholar 

  • D’Adamo DR, Anderson SE, Albritton K et al (2005) Phase II study of doxorubicin and bevacizumab for patients with metastatic soft-tissue sarcomas. J Clin Oncol 23(28):7135–7142

    Article  PubMed  Google Scholar 

  • De Araujo RA, Araujo BJ (2014) Desmoplastic small round cell tumor: report of 2 cases treated with chemotherapy alone or in combination with bevacizumab. Case Rep Oncol 7(1):102–108

    Article  PubMed  PubMed Central  Google Scholar 

  • Duffaud F, Sleijfer S, Litiere S et al (2015) Hypertension (HTN) as a potential biomarker of efficacy in pazopanib –treated patients with advanced non-adipocytic soft tissue sarcoma. A retrospective study based on European Organisation for Research and Treatment of Cancer (EORTC) 62043 and 62072 trials. Eur J Cancer 51(17):2615–2623

    Article  CAS  PubMed  Google Scholar 

  • Fata F, O’Reilly E, Ilson D et al (1999) Paclitaxel in the treatment of patients with angiosarcoma of the scalp or face. Cancer 86(10):2034–2037

    Article  CAS  PubMed  Google Scholar 

  • Folkman J (1995) Tumour angiogenesis. In: Mendelsohn J (ed) The molecular basis of cancer. WB Saunders, Philadelphia, pp 206–232

    Google Scholar 

  • Frezza AM, Benson C, Judson IR (2014) Pazopanib in advanced desmoplastic small round cell tumours: a multi-institutional experience. Clin Sarcoma Res 4:7

    Article  PubMed  PubMed Central  Google Scholar 

  • George S, Merriam P, Maki RG et al (2009) Multicenter phase II trial of sunitinib in the treatment of nongastrointestinal stromal tumor sarcomas. J Clin Oncol 27(19):3154–3160

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Glade Bender JL, Adamson PC, Reid JM et al (2008) Phase I trial and pharmacokinetic study of bevacizumab in pediatric patients with refractory solid tumors: a children’s oncology group study. J Clin Oncol 26(3):399–405

    Article  PubMed  Google Scholar 

  • Glade Bender JL, Lee A, Reid JM (2013) Phase I pharmacokinetic and pharmacodynamics study of pazopanib in children with soft tissue sarcoma and other refractory solid tumors: a children’s oncology group phase I consortium report. J Clin Oncol 31(24):3034–3043

    Article  PubMed  PubMed Central  Google Scholar 

  • Gounder MM, Lefkowitz RA, Keohan ML et al (2011) Activity of Sorafenib against desmoid tumour/ deep fibromatosis. Clin Cancer Res 17(12):4082–4090

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Graeven U, Andre N, Achilles E et al (1999) Serum levels of vascular endothelial growth factor and basic fibroblast growth factor in patients with soft tissue sarcoma. J Cancer Res Clin Oncol 125(10):577–581

    Article  CAS  PubMed  Google Scholar 

  • Haas RL, Gelderblom H, Sleijfer S et al (2015) A phase I study on the combination of neoadjuvant radiotherapy plus pazopanib in patients with locally advanced soft tissue sarcoma of the extremities. Acta Oncol 54(8):1195–1201

    Article  CAS  PubMed  Google Scholar 

  • Hayes AJ, Mostyn-Jones A, Koban MU et al (2004) Serum vascular endothelial growth factor as a tumour marker in soft tissue sarcoma. Br J Sur 91(2):242–247

    Article  CAS  Google Scholar 

  • Hensley ML, Sill MW, Scribner DR Jr et al (2009) Sunitinib malate in the treatment of recurrent or persistent leiomyosarcoma: a gynecologic oncology group phase II study. Gynecol Oncol 115(3):460–465

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hensley ML, Miller A, O’Malley DM et al (2015) Randomized phase III trial of gemcitabine plus docetaxel plus bevacizumab or placebo as first-line treatment for metastatic uterine leiomyosarcoma: an NRG oncology/gynecologic oncology group study. J Clin Oncol 33(10):1180–1185

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Itakura E, Yamamoto H, Oda Y et al (2008) Detection and characterisation of vascular endothelial growth factors and their receptors in a series of angiosarcomas.J. Sur Oncol 92(1):74–81

    Article  Google Scholar 

  • Judson I, Verweij J, Gelderblom H et al (2014a) Doxorubicin alone versus intensified doxorubicin plus ifosfamide for first-line treatment of advanced or metastatic soft–tissue sarcoma: a randomised controlled phase 3 trial. Lancet Oncol 15(4):415–423

    Article  CAS  PubMed  Google Scholar 

  • Judson I, Scurr M, Gardner K et al (2014b) Phase II study of cediranib in patients with advanced gastrointestinal stromal tumors or soft tissue sarcoma. Clin Cancer Res 20(13):3603–3612

    Article  CAS  PubMed  Google Scholar 

  • Kasper B, Hohenberger P (2011) Pazopanib - a promising new agent in the treatment of soft tissue sarcomas. Future Oncol 7(12):1373–1383

    Article  CAS  PubMed  Google Scholar 

  • Kasper B, Sleijfer S, Litiere S et al (2014) Long-term responders and survivors on pazopanib for advanced soft tissue sarcomas: subanalysis of two European Organisation for Research and Treatment of Cancer (EORTC) clinical trials 62043 and 62072. Ann Oncol 25(3):719–724

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kim SY, Kim DH, Lee HJ et al (2011) Treatment of disseminated classic type of Kaposi’s sarcoma with paclitaxel. Ann Dermatol 23(4):504–507

    Article  PubMed  PubMed Central  Google Scholar 

  • Kuhnen C, Lehnhardt M, Tolnay E et al (2000) Patterns of expression and secretion of vascular endothelial growth factor in malignant soft tissue tumours. J Cancer Res Clin Oncol 126(4):219–225

    Article  CAS  PubMed  Google Scholar 

  • Kummar S, Allen D, Monks A et al (2013) Cediranib for metastatic alveolar soft part sarcoma. J Clin Oncol 31(18):2296–2302

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Letsa I, Benson C, Al-Muderis O et al (2014) Angiosarcoma of the face and scalp: effective treatment in the older patient. J Geriatr Oncol 5(3):276–280

    Article  PubMed  Google Scholar 

  • Mahmood ST, Agresta S, Vigil CE et al (2011) Phase ii study of sunitinib malate, a multitargeted tyrosine kinase inhibitor in patients with relapsed or refractory soft tissue sarcomas. Focus on three prevalent histologies: leiomyosarcoma liposarcoma and malignant fibrous histiocytoma. Int J Cancer 129(8):1963–1969

    Article  PubMed  PubMed Central  Google Scholar 

  • Maki R, D’Adamo DR, Keohan ML et al (2009) Phase II study of sorafenib in patients with metastatic or recurrent sarcomas. J Clin Oncol 27(19):3133–3140

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Martin-Liberal J, Benson C, McCarty H et al (2013) Pazopanib is an active treatment in desmoid tumour/ aggressive fibromatosis. Clin Sarcoma Res 3(1):13

    Article  PubMed  PubMed Central  Google Scholar 

  • Maruzzo M, Martin-Liberal J, Messiou C et al (2015) Pazopanib as first line treatment for solitary fibrous tumours: the Royal Marsden Hospital experience. Clin Sarcoma Res 5:5

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • von Mehren M, Rankin C, Goldblum JR et al (2012) Phase 2 southwest oncology group- directed intergroup trial (SO505) of sorafenib in advanced soft tissue sarcomas. Cancer 118(3):770–776

    Article  Google Scholar 

  • Mross K, Fros A, Steinbild S et al (2012) A phase I dose escalation study of regorafenib (BAY 73-4506), an inhibitor of oncogenic, angiogenic and stromal kinases, in patients with advanced solid tumors. Clin Cancer Res 18(9):2658–2667

    Article  CAS  PubMed  Google Scholar 

  • Munhoz RR, D’Angelo SP, Gounder MM et al (2015) A phase Ib/II study of gemcitabine and Docetaxel in combination with Pazopanib for the Neoadjuvant treatment of soft tissue sarcomas. Oncologist 20(11):1245–1246

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Park MS, Patel SR, Ludwig JA et al (2011) Activity of temozolomide and bevacizumab in the treatment of locally advanced recurrent and metastatic haemangiopericytoma and malignant solitary fibrous tumor. Cancer 117(21):4939–4947

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Penel N, Bui BN, Bay JO et al (2008) Phase II trial of weekly paclitaxel for unresectable angiosarcoma: the ANGIOTAX study. J Clin Oncol 26(32):5269–5274

    Article  CAS  PubMed  Google Scholar 

  • Potti A, Ganti AK, Tendulkar K et al (2004) Determination of vascular endothelial growth factor (VEGF) overexpression in soft tissue sarcomas and the role of overexpression in leiomyosarcoma. J Cancer Res Clin Oncol 130(1):52–56

    Article  CAS  PubMed  Google Scholar 

  • Ray-Coquard I, Italiano A, Bompas E et al (2012) Sorafenib for patients with advanced angiosarcoma: a phase II trial from the French sarcoma group (GSF/GETO). Oncologist 17(2):260–266

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Ray-Coquard IL, Domont J, Tresc-Bruneel E et al (2015) Paclitaxel given once per week with or without bevacizumab in patients with advanced angiosarcoma: a randomized phase II trial. J Clin Oncol 33(25):2797–2802

    Article  CAS  PubMed  Google Scholar 

  • Ronellenfitsch U, Dimitrakopoulou-Strauss A, Jakob J et al (2016) Preoperative therapy with pazopanib in high risk soft tissue sarcoma: a phase II window of opportunity study by the German Interdisciplinary sarcoma group (GISG-04/NOPASS). BMJ Open 6(1):e009558

    Article  PubMed  PubMed Central  Google Scholar 

  • Schlemmer M, Reichardt P, Verweij J et al (2008) Paclitaxel in patients with advanced angiosarcomas of soft tissue: a retrospective study of the EORTV soft tissue and bone sarcoma group. Eur J Cancer 44(16):2433–2436

    Article  CAS  PubMed  Google Scholar 

  • Shintani K, Matsumine A, Kusuzaki K et al (2006) Expression of hypoxia-inducible factor (HIF)-1alpha as a biomarker of outcome in soft tissue sarcomas. Virchows Arch 449(6):673–681

    Article  CAS  PubMed  Google Scholar 

  • Sleijfer S, Ray-Coquard I, Papai Z et al (2009) Pazopanib, a multikinase angiogenesis inhibitor in patients with relapsed or refractory advanced soft tissue sarcoma: a phase II study from the European organisation for research and treatment of cancer- soft tissue and bone sarcoma group (EORTC study 62043). J Clin Oncol 27(19):3126–3132

    Article  CAS  PubMed  Google Scholar 

  • Stacchiotti S, Grosso F, Negri T et al (2010) Tumor response to sunitinib malate in clearcell sarcoma. Ann Oncol 21(5):1130–1131

    Article  CAS  PubMed  Google Scholar 

  • Stacchiotti S, Negri T, Zaffaroni N et al (2011) Sunitinib in advanced alveolar soft part sarcoma: evidence of a direct antitumor effect. Ann Oncol 22(7):1682–1690

    Article  CAS  PubMed  Google Scholar 

  • Stacchiotti S, Negri T, Libertini M et al (2012) Sunitinib malate in solitary fibrous tumor (SFT). Ann Oncol 23(12):3171–3179

    Article  CAS  PubMed  Google Scholar 

  • Stacchiotti S, Pantaleo MA, Astolfi A et al (2014) Activity of sunitinib in extraskeletal myxoid chondrosarcoma. Eur J Cancer 50(9):1657–1664

    Article  CAS  PubMed  Google Scholar 

  • Uldrick TS, Wyvill KM, Kumar P et al (2012) Phase II study of bevacizumab in patients with HIV associated Kaposi’s sarcoma receiving antiretroviral therapy. J Clin Oncol 30(13):1476–1483

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Van der Graaf WT, Blay JY, Chawla SP et al (2012) Pazopanib for metastatic soft tissue sarcoma (PALETTE): a randomised double-blind, placebo-controlled phase 3 trial. Lancet 379(9829):1879–1886

    Article  PubMed  Google Scholar 

  • Verschraegen CF, Arias-Pulido H, Lee SJ et al (2012) Phase IB study of the combination of docetaxel, gemcitabine and bevacizumab in patients with advanced of recurrent soft tissue sarcoma: the Axtell regimen. Ann Oncol 23(3):785–790

    Article  CAS  PubMed  Google Scholar 

  • Yoon SS, Segal NH, Olshen AB et al (2004) Circulating angiogenic factor levels correlate with extent of disease and risk of recurrence in patients with soft tissue sarcoma. Ann Oncol 15(8):1261–1268

    Article  CAS  PubMed  Google Scholar 

  • Yoon SS, Duda DG, Karl DL et al (2011) Phase II study of neoadjuvant bevacizumab and radiotherapy for resectable soft tissue sarcomas. Int J Radiat Oncol Biol Phys 81(4):1081–1090

    Article  CAS  PubMed  Google Scholar 

  • Zhang L, Hannay JA, Liu J et al (2006) Vascular endothelial growth factor overexpression by soft tissue sarcoma cells: implications for tumor growth, metastasis and chemoresistance. Cancer Res 66(17):8770–8778

    Article  CAS  PubMed  Google Scholar 

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Kasper, B., Benson, C. (2017). The Value of Anti-Angiogenics in Soft Tissue Sarcoma Therapy. In: Marmé, D. (eds) Tumor Angiogenesis. Springer, Cham. https://doi.org/10.1007/978-3-319-31215-6_20-1

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  • DOI: https://doi.org/10.1007/978-3-319-31215-6_20-1

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