Angiosarcoma: adaptive designs leveraging vascular biology and antiangiogenic repurposing.

Authors

Elhadi Iich, Bavani Kannan, Yi Chye Law, Jason Yongsheng Chan

Published in

Expert review of anticancer therapy. Aug 05, 2026. Epub Aug 05, 2026.

Abstract

Angiosarcoma is a rare and aggressive vascular malignancy characterized by substantial clinical and molecular heterogeneity. Grouping UV-associated cutaneous, radiation-associated, and visceral tumors within unselected clinical trials may obscure treatment effects in biologically distinct subgroups.
This narrative review examines cytotoxic and anti-angiogenic therapy, immunotherapy, oncolytic virotherapy, non-canonical vascular targets, and advances in multiomic, spatial, and proteomic profiling. It also evaluates adaptive and Bayesian trial designs as strategies for biomarker-enriched development. Literature was identified through PubMed and AI-assisted discovery, with relevant clinical trial reports, conference abstracts, and regulatory guidance included through July 2026.
Current systemic therapies provide modest population-level benefit and generally limited durability. Emerging evidence supports biologically distinct treatment-responsive subsets, including selected UV-associated cutaneous and secondary angiosarcomas, although validated predictive biomarkers remain lacking. Progress will require integration of molecular, immune, spatial, and protein-level features into patient selection. Adaptive and enrichment-based trial designs may reduce dilution of subgroup-specific signals and support the transition from histology-defined cohorts toward mechanistically stratified treatment.

PMID:
42554740
Bibliographic data and abstract were imported from PubMed on 06 Aug 2026.

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