Angiology: Open Access
Open Access

Novel Therapeutic Approaches in the Treatment of Angiosarcoma

Ruth Feldman^{* *}Correspondence: Ruth Feldman, Department of Clinical Cardiology, Alzahra University, Tehran, Iran, Email:

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Description

Angiosarcoma, a rare and aggressive malignancy originating from the endothelial cells lining blood vessels, presents significant treatment challenges. Characterized by its heterogeneous nature and tendency to metastasize, angiosarcoma often exhibits resistance to standard therapies, leading to a chronic prognosis for many patients. Given the urgency of improving treatment outcomes, researchers and clinicians are increasingly exploring novel therapeutic strategies that provides significant hope. This article reviews recent advancements in angiosarcoma treatment, focusing on targeted therapies, immunotherapy, and the evidence of personalized medicine.

Targeted therapies

Targeted therapies have emerged as a pivotal approach in the management of angiosarcoma, driven by the identification of specific genetic alterations in tumor cells. One of the most notable targets is the Vascular Endothelial Growth Factor Receptor (VEGFR) pathway, which plays an important role in angiogenesis. Agents like sunitinib and pazopanib have been utilized to inhibit this pathway, effectively reducing tumor vascularization and growth. Clinical studies have reported improved progression-free survival rates in patients treated with these drugs, marking a significant step forward in angiosarcoma management. Moreover, recent investigations into the PI3K/AKT/mTOR signaling pathway, frequently activated in angiosarcoma, have provided significant evidences for therapy. The mTOR inhibitor everolimus is currently being evaluated in clinical trials, with early results suggesting that it may help in slowing disease progression. The specificity of these therapies is particularly important, as they aim to minimize collateral damage to healthy tissues, which directs a critical concern in the treatment of aggressive tumors like angiosarcoma.

Immunotherapy

Immunotherapy represents a significant approach in cancer treatment, and its application in angiosarcoma is gaining traction. Angiosarcomas often develop mechanisms to avoid immune detection, making them suitable pretenders for immunotherapeutic strategies. Immune checkpoint inhibitors, such as nivolumab and pembrolizumab, have shown evidence in early studies, particularly for patients with high tumor mutational burdens. These agents work by blocking inhibitory signals that prevent T cells from attacking tumor cells, thereby stimulating the immune response. In addition to checkpoint inhibitors, adoptive cell transfer techniques, including CARTcell therapy, are being explored. This innovative approach involves engineering a patient’s T cells to recognize specific antigens on angiosarcoma cells, enhancing their ability to target and destroy tumors. Early clinical trials suggest that this personalized immunotherapy could lead to durable responses, although more research is needed to determine optimal patient selection and treatment protocols.

Personalized medicine

The emergence of personalized medicine, which modifies treatment based on individual genetic and molecular profiles, holds particular promise for angiosarcoma patients. Next- Generation Sequencing (NGS) technologies have facilitated comprehensive genomic profiling of tumors, allowing clinicians to identify actionable mutations that could inform therapy choices. For instance, angiosarcomas may foster mutations in genes like TP53 or NF2, which might respond to specific targeted therapies. By integrating biomarker-driven strategies into clinical practice, oncologists can provide more effective and individualized treatment plans. This approach minimizes the dependence on conventional theory one-size-fits-all methodologies and increases the likelihood of positive outcomes, ultimately improving the quality of life for patients.

Combination therapies

Combining immunotherapy with targeted therapies is particularly signficant. For example, pairing immune checkpoint inhibitors with angiogenesis inhibitors may enhance the overall anti-tumor response by simultaneously disrupting tumor growth and activating immune surveillance. Ongoing clinical trials are assessing these combinations to determine their effectiveness and safety in angiosarcoma patients. Moreover, integrating chemotherapy with novel agents is also being evaluated. Although conventional chemotherapy has shown limited efficacy against angiosarcoma, combining it with targeted therapies could improve outcomes. Research continues to identify the most effective combinations and treatment sequences, aiming to maximize therapeutic benefit while minimizing toxicity.

Conclusion

Angiosarcoma remains a rare and highly aggressive neoplasm characterized by endothelial cell malignancy, often associated with poor prognosis due to its propensity for early metastasis and resistance to conventional therapies. Despite advances in surgical resection, radiotherapy, and chemotherapy, the clinical management of angiosarcoma remains challenging, particularly in cases of advanced or recurrent disease. Recent developments in molecular oncology have elucidated key genetic and epigenetic alterations underlying angiosarcoma pathogenesis, including mutations in tumor suppressor genes. Continued exploration of the molecular perspective of angiosarcoma, coupled with the development of novel therapeutic combinations, provides significant way for improved survival and quality of life in patients affected by this destructive malignancy.