To determine efficacy and safety of bevacizumab, a recombinant humanized antibody
against vascular endothelial growth factor (VEGF), in the treatment of metastatic
or locally advanced angiosarcoma and epithelioid hemangioendotheliomas.
In this single-arm phase II trial, 32 patients were enrolled and they received bevacizumab
15 mg/kg IV infusion in 21-day cycles. Patients had disease that was deemed not surgically
resectable, Eastern Cooperative Oncology Group (ECOG) performance status of ≤1, adequate
organ function and had not received any radiation treatment in the last 28 days.
Of the 30 patients evaluated for efficacy and toxic effect, four (two angiosarcoma
and two epithelioid hemangioendothelioma; 17%) had a partial response. Fifteen patients
(11 angiosarcoma and 4 epithelioid hemangioendothelioma; 50%) showed stable disease
with a mean time to progression of 26 weeks. Bevacizumab was well tolerated with only
one grade 4 adverse event. Expected known toxic effects of the drug were manageable.
Bevacizumab is an effective and well-tolerated treatment for metastatic or locally
advanced angiosarcoma and epithelioid hemangioendotheliomas. Further phase III studies
of bevacizumab in combination with other chemotherapeutic agents and/or radiation
treatment are warranted.