Targeted therapy with propranolol and metronomic chemotherapy combination: sustained complete response of a relapsing metastatic angiosarcoma

Abstract

We report here a case of a 69-year-old woman with a relapsing metastatic angiosarcoma treated with a combination of metronomic chemotherapy and propranolol. The beta blockers were added since the tumour was positive for betaadrenergic receptor. A complete response was quickly obtained and lasted for 20 months. With this case, the combination of metronomic chemotherapy and propranolol in angiosarcoma warrants additional studies and illustrates the potential of metronomics to generate innovative yet inexpensive targeted therapies for both high-income and low-/middle-income countries.

Keywords: angiosarcoma; beta-blockers; celecoxib; cyclophosphamide; drug repositioning; etoposide; metronomic chemotherapy; palliative treatment; propranolol.

Figure 1.. Histomorphology of specimen. A: Photomicrograph of cutaneous angiosarcoma at low power showing an infiltrative tumour. B: Higher power shows tumour cells lining vascular channels. C: Another photo showing the marked cytological atypia in the tumour cells lining vascular channels. D: Another higher power to highlight the cytological atypia of these vasoformative tumour cells. (A—haematoxylin-eosin, X40; B and C—X200; D—X400.)