Regression of primary cardiac angiosarcoma and metastatic nodules following propranolol as a single agent treatment

Area of Science:

• Oncology
• Cardiology
• Pharmacology

Background:

• Angiosarcoma is the most common malignant cardiac tumor, characterized by high lethality and resistance to conventional therapies.
• Current treatment options offer limited survival benefits, with a median survival of approximately 4 months for cardiac angiosarcoma.
• The beta blocker propranolol is an emerging therapeutic agent for angiosarcoma, showing improved survival when combined with standard treatments.

Purpose of the Study:

• To investigate the efficacy of propranolol as a single-agent therapy for primary cardiac angiosarcoma with metastatic disease.
• To report the long-term outcomes of a patient with advanced cardiac angiosarcoma treated solely with propranolol.

Main Methods:

• A case report of a 61-year-old woman diagnosed with primary cardiac angiosarcoma and liver and lung metastases.
• The patient opted for single-agent treatment with propranolol, declining conventional anti-cancer therapies.
• Treatment response was assessed over 12 months using imaging techniques, including PET-CT.

Main Results:

• The patient experienced substantial debulking and size reduction of the mediastinal mass after 12 months of propranolol therapy.
• Metastatic nodules in the liver and lungs stabilized or resolved, with no evidence of hyper-metabolic activity on PET-CT.
• This represents the first reported instance of long-term efficacy for propranolol as a monotherapy in angiosarcoma.

Conclusions:

• Propranolol monotherapy demonstrated significant anti-cancer efficacy in a patient with advanced cardiac angiosarcoma.
• These findings suggest that propranolol may be a viable therapeutic option for angiosarcoma when conventional treatments are declined or ineffective.
• Further research is warranted to explore the role of propranolol as a single-agent treatment for angiosarcoma.