Abstract
Angiosarcoma is the most common malignant cardiac tumor. Cardiac angiosarcoma is a highly lethal neoplasm that is largely resistant to conventional anti-cancer therapy. Mean survival of patients with cardiac angiosarcoma is only 4 months, and almost all patients will succumb to the disease within 1 year. The beta blocker propranolol is an emerging therapy against angiosarcoma. When combined with conventional therapies, propranolol increases progression free and overall survival in patients with this tumor type. It is currently unknown if propranolol is capable of showing anti-cancer efficacy as a single agent therapy. We report a case of a 61 year old woman diagnosed with primary cardiac angiosarcoma and liver and lung metastases. This patient chose to decline conventional therapy, and instead was prescribed the beta blocker propranolol as a single agent treatment. After 12 months, the mediastinal mass substantially debulked and decreased in size, and the metastatic nodules stabilized or resolved with no evidence of hyper-metabolic activity on PET-CT. This is the first reported data showing long term efficacy of the beta blocker propranolol as a single agent therapy against angiosarcoma.
Highlights
Primary cardiac neoplasms are exceptionally rare tumors, with an autopsy incidence of 0.0001% to 0.03% [1]
Cardiac angiosarcomas predominantly occur in males who are less than 65 years of age [4, 5], and have been shown, at least in some cases, to display a familial pattern of inheritance corresponding to a germline POT1 mutation [6, 7]
After 12 months of propranolol as a single agent therapy, significant debulking www.impactjournals.com/oncoscience and decreased size of the residual mediastinal mass was observed on PET-CT scans, with resolution of pericardial effusion (Figure 2A & Figure 2B)
Summary
Primary cardiac neoplasms are exceptionally rare tumors, with an autopsy incidence of 0.0001% to 0.03% [1]. Emerging evidence from a number of retrospective clinical analyses and prospective case reports indicates www.impactjournals.com/oncoscience that the beta blocker propranolol exhibits clinical efficacy against primary and metastatic angiosarcomas [19,20,21,22,23,24,25,26].
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