Pazopanib shows activity and manageable safety in paclitaxel-pretreated cutaneous angiosarcoma, offering a potential second-line therapy option.
Pazopanib Trial Design and Outcomes
PAZOPANIB, an anti-cancer medication used to treat kidney cancer, has produced acceptable responses in treating paclitaxel-pretreated angiosarcoma. The Japan Clinical Oncology Group conducted a single-arm, confirmatory trial where 30 patients from 60 institutions with cutaneous angiosarcoma were orally administered a dose of 800 mg of pazopanib daily, with the primary endpoint being progression-free survival.
The median progression-free survival was 2.8 months, 80% confidence interval 2.1 to 3.9 months, however, the overall survival was notable at a median of 12.1 months, 95% confidence interval 8.9 to 28.8 months. The objective response rate was 31.8% and the disease control rate was 63.6% in this heavily pretreated cohort.
Safety and Tolerability
Treatment with pazopanib produced frequent nonhematologic adverse events, with 93.3% of patients experiencing grade 2 or greater events and 70% experiencing grade 3 or greater nonhematologic toxicity. Importantly, no treatment-related deaths occurred in the study population. The authors compared outcomes against retrospective data for second-line docetaxel following paclitaxel and concluded that pazopanib delivered better than expected response and survival metrics while maintaining a manageable safety profile.
Implications and Further Steps
Although the prespecified progression-free survival threshold was not achieved, the response rate and overall survival results suggest pazopanib is active in paclitaxel-pretreated primary cutaneous angiosarcoma and may represent a viable therapeutic option. Clinicians should weigh the high incidence of nonhematologic toxicity against the potential for clinical benefit and consider pazopanib where alternative systemic options are limited. The study supports considering pazopanib in multidisciplinary treatment planning and highlights the need for further investigation to define optimal sequencing and patient selection.
Reference
Oashi K et al. Efficacy and safety of pazopanib in patients with paclitaxel-pretreated primary cutaneous angiosarcoma in Japan: Results of the Japan Clinical Oncology Group single-arm confirmatory trial (JCOG1605). Br J Dermatol. 2026:ljag07;doi: 10.1093/bjd/ljag071. Epub ahead of print.
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