(P 471) COMBINATION CHEMOTHERAPY WITH GEMCITABINE AND PACLITAXEL: A HIGHLY EFFICACIOUS AND BETTER TOLERATED OPTION FOR ANGIOSARCOMA

Objective: Angiosarcoma (AS) is an aggressive soft tissue sarcoma with limited treatment options and frequent recurrence/metastasis. Current guidelines recommend single-agent Paclitaxel or Gemcitabine-based regimens, but Gemcitabine/Docetaxel causes significant myelosuppression and QoL-impacting toxicities. This retrospective review explored whether Gemcitabine/Paclitaxel could improve clinical outcomes with decreased toxicity.

Methods: Four AS patients received Gemcitabine 900 mg/m2 (D1, D8) and Paclitaxel 90 mg/m2 (D1, D8) every 21 days.

Results: Pt A (37F, metastatic breast AS): This patient was diagnosed with AS 5 yrs ago and then had recurrence after lumpectomy and chemotherapy. Pt has had clinical response and has continued on this regimen for residual disease for the last 6 months with minimal toxicities after progressing on prior treatments with Pazopanib and Pembrolizumab.
Pt B (49F, metastatic breast AS): Diagnosed with AS 3 years ago and has lung and bone mets and has had clinical response and continuing on treatments for residual disease for 7 months with minimal toxicities after progressing on Doxorubicin and Pembrolizumab.
Pt C (46F, forearm epithelioid AS): Developed extensive AS in background of right arm lymphedema. Has a complete response with minimal toxicities for the last 2 years.
Pt D (68M, bladder AS with intestinal mets): Achieved initial clinical complete response for 9 months, then resumed treatment upon recurrence, maintaining complete clinical response with minimal toxicities.

Conclusion: In all cases, Gemcitabine/Paclitaxel led to significant clinical responses and decreased toxicities compared to standard treatments (single-agent Paclitaxel, Anthracycline, other Gemcitabine regimens). Pts A and B have stable disease, and Pts C and D had complete responses. The favorable side effect profile improved QoL despite long-term use and prolonged chemotherapy durations. This provides promising evidence for Gemcitabine/Paclitaxel combination therapy in AS, requiring further studies.