Angiosarcoma
Prepared with OnCo (onco.cc/prep/angiosarcoma/). Orientation, not medical advice; your team knows your case.
My details
What I know, what is unclear, changes to discuss
Saved in this browserMy questions
18 on the sheet- 1.What is my exact diagnosis, stage, and grade, and which tests established them?
- 2.Which biomarkers have been tested on my tumour (for example MYC amplification, Tumour mutational burden and ultraviolet signature, CD31, ERG and FLI1 endothelial markers, KDR and PLCG1 mutations, PTPRB and PLCG1 in secondary breast tumours), and what were the results?
- 3.Which subtype is my cancer, and does that change the recommended treatment?
- 4.Is germline (inherited) genetic testing recommended for me or my family?
- 5.For my situation (localised cutaneous (scalp, face)), which of the standard options do you recommend and why?
- 6.Am I a candidate for Paclitaxel / nab-paclitaxel, and what side effects should I expect?
- 7.For my situation (radiation-associated breast angiosarcoma), which of the standard options do you recommend and why?
- 8.Am I a candidate for Paclitaxel / nab-paclitaxel, Doxorubicin, and what side effects should I expect?
- 9.For my situation (advanced, first line), which of the standard options do you recommend and why?
- 10.Am I a candidate for Paclitaxel / nab-paclitaxel, Doxorubicin, Pegylated liposomal doxorubicin, and what side effects should I expect?
- 11.How do the results of ANGIOTAX apply to someone like me?
- 12.For my situation (later lines), which of the standard options do you recommend and why?
- 13.Am I a candidate for Gemcitabine, Pazopanib, Nivolumab or related drugs, and what side effects should I expect?
- 14.Are there clinical trials I could join, for example of Immune checkpoint inhibitors, Nivolumab, Ipilimumab, Pazopanib?
- 15.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
- 16.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
- 17.I read that “Multifocal scalp disease escapes even wide surgery and radiotherapy”. How does that affect my plan?
- 18.I read that “Median survival with metastases remains under a year”. How does that affect my plan?
Tests and results to bring
Biomarker results to ask for: MYC amplification (secondary angiosarcoma), Tumour mutational burden and ultraviolet signature (scalp and face; immunotherapy response), CD31, ERG and FLI1 endothelial markers, KDR and PLCG1 mutations, PTPRB and PLCG1 in secondary breast tumours.
Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.
The treatments I may be offered
- Localised cutaneous (scalp, face): Wide excision where feasible plus wide-field radiotherapy; neoadjuvant or definitive weekly paclitaxel with radiotherapy when surgery is not possible. (IMRT / IGRT (modern external beam), Paclitaxel / nab-paclitaxel)
- Radiation-associated breast angiosarcoma: Total mastectomy with wide skin excision; consider neoadjuvant paclitaxel; re-irradiation is limited by prior dose. (Paclitaxel / nab-paclitaxel, Doxorubicin)
- Advanced, first line: Weekly paclitaxel (ANGIOTAX) or doxorubicin-based chemotherapy; liposomal doxorubicin in frail patients. (Paclitaxel / nab-paclitaxel, ANGIOTAX, Doxorubicin, Pegylated liposomal doxorubicin)
- Later lines: Gemcitabine, pazopanib; checkpoint inhibitors (nivolumab plus ipilimumab) for cutaneous scalp and face disease, off label or in trials. (Gemcitabine, Pazopanib, Nivolumab, Ipilimumab, Immune checkpoint inhibitors)
From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.