Episode 41 - Pazopanib for primary cutaneous angiosarcoma

In this episode of BJD Talks, Sam and Meera discuss the article ‘Efficacy and safety of pazopanib in patients in Japan with primary cutaneous angiosarcoma pretreated with paclitaxel: results of the Japan Clinical Oncology Group single-arm confirmatory trial (JCOG1605)’ by Oashi et al. The full article can be accessed at https://doi.org/10.1093/bjd/ljag071

*This podcast was generated by an AI tool created by 67Bricks for the British Association of Dermatologists*

Transcript

SPEAKER_00 0:00

Welcome to BJD Talks, the official podcast of the BJD. I'm Sam.

SPEAKER_01 0:04

And I'm Mira. In this episode, we will be discussing the article by Kohe Oashi et al. Efficacy and Safety of Pazopainib in patients in Japan with primary cutaneous angiosarcoma pre-treated with Paclitaxel. Results of the Japan Clinical Oncology Group single arm confirmatory trial from March 2026 and included in the July 2026 issue.

SPEAKER_00 0:29

Thanks, Mira. Let's set the stage. Primary cutaneous angiosarcoma is a rare aggressive skin cancer that often appears on the scalp or face of older adults. Treatment poses significant challenges. While the standard first-line therapy, Paclitaxyl, is used, not all patients respond, and resistance or side effects typically emerge over time.

SPEAKER_01 0:51

Precisely. This study focused on Pazopainib as a second-line treatment for those previously treated with Paclitaxel. Pazopainib, a multitargeted tyrosine kinase inhibitor, is already employed in advanced soft tissue sarcomas. But its efficacy in primary cutaneous angiosarcoma hadn't been well established until now.

SPEAKER_00 1:12

A single-arm trial in Japan recruited 30 patients from 15 institutions, all with histologically confirmed primary cutaneous angiosarcoma. These patients were previously treated with Paclitaxyl but stopped due to resistance or intolerance.

SPEAKER_01 1:28

Participants received an initial daily dose of 800 mg of Pazopainib. The primary objective was progression-free survival, or PFS, while secondary endpoints included overall survival, response rates, and safety outcomes. A historical comparison group treated with DOCitaxil was used for context.

SPEAKER_00 1:48

The results make for interesting reading. The median PFS was 2.8 months, slightly below the target of 3 months. However, the response rate was 31.8%, and the median overall survival reached 12.1 months, both of which outperformed historical DOCAxil data.

SPEAKER_01 2:06

Safety data was also worth noting. 93% experienced non-hematological adverse events of grade 2 or higher, and 70% had grade 3 events, though there were no grade 4 toxicities or treatment-related deaths. Notably, older patients tolerated the regimen well with monitoring and dose adjustments.

SPEAKER_00 2:27

Yes, the results highlight potential clinical relevance. While PFS was unspectacular, the better response rate and overall survival suggest Pazopanib could be a reasonable second-line therapy, particularly for older patients grappling with toxicity from other treatments.

SPEAKER_01 2:43

Still, it's important to acknowledge the study's limitations. Being non-randomized and single-arm makes broad conclusions tricky, and the small sample size, while unavoidable in such a rare disease, adds further challenges.

SPEAKER_00 2:57

Indeed, the authors discussed the need for tailored systemic treatments for rare cancers like cutaneous angiosarcoma. This raises an important question. How can we innovate for rare cancers when robust randomized trials aren't always feasible?

SPEAKER_01 3:13

That's an excellent point, Sam. Future avenues might involve biomarker-guided research and leveraging real-world data. Immune checkpoint inhibitors, as mentioned in the article, show promise, particularly with UV-associated angiosarcomas, where the tumour mutational burden is high.

SPEAKER_00 3:31

Combination therapies could also hold potential, pairing anti-angiogenic agents with immunotherapy or combination immunotherapy. This study certainly paves the way for more investigation.

SPEAKER_01 3:42

To summarise, while ParserPainIb didn't redefine progression-free survival, the response rate and safety profile make it a viable second-line option. Rare cancers like primary cutaneous angiosarcoma remain exceptionally challenging, but incremental advances like this study provide much needed insight.

SPEAKER_00 4:01

Absolutely, Mira. It's a reminder of the impact even small strides can make for patients facing such tough diagnoses. That concludes this episode of BJD Talks. Thank you for listening.

SPEAKER_01 4:12

Until next time, take care and keep advancing the field of dermatology.