Cardiac tumors medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Template:Dj

Overview

Most of the Cardiac tumors are treated with surgical management. Malignant primary cardiac tumors have a predisposition for rapid metastasis spread.

  • Systemic neoadjuvant therapy should be aggressively explored in hemodynamically stable patients with localized disease because it permits: (a) quicker removal by shrinking the tumor size and (b) a decrease in the likelihood of systemic recurrence

Medical Treatment of Cardiac Tumors

Malignant recurrent effusions may require the use of a sclerosing agent or drainage with a subxiphisternal windows or percutaneous approach.


Cardiac Tumors Medical Management
Tumor Treatment
Cardiac Lymphoma Rituximab is an anti-CD20 monoclonal antibody that typically produces remission in a wide range of B-cell non-Hodgkin lymphomas.

MOA: Activation of antibody-dependent, cell-mediated cytotoxicity, complement-mediated lysis, phagocytosis of antibody-coupled tumor cells, and activation of cell death appear to constitute its mode of action.[1]

Sarcoma Doxorubicin and Ifosfamide alternative regimen Gemcitabine/Docetaxel
  • Gemcitabine: MOA :Gemcitabine is a nucleoside analogue that induces apoptosis in cancerous cells during DNA formation to exert its antitumor effects.[2]
Angiosarcoma Paclitaxel
  • MOA: Dr. Horwitz found that Paclitaxel inhibits cell division by promoting the assembly of stable microtubules, particularly from -tubulin heterodimers. It inhibits their depolymerization; as a result, vulnerable cells are detained in the G2/M stage of mitosis.[3]

Other Vinca alkaloids block microtubule arrangement.[3]

Prominent targeted therapy Anti-angiogenic agents
  • Pazopanib MOA suppression of the intracellular tyrosine kinase of VEGF receptor (VEGFR) and PDGF receptor (PDGFR) (PDGFR).[4]
  • Sorafenib MOA a potent soluble epoxide hydrolase inhibitor.[4]
Undifferentiated pleomorphic sarcomas Pembrolizumab
  • MOA:blocks a protein called PD-1 on the surface of certain immune cells called T-cells. Blocking PD-1 triggers the T-cells to find and kill cancer cells.[5]

References

  1. Nakagawa Y, Ikeda U, Hirose M, Ubukata S, Katsuki TA, Kaminishi Y; et al. (2004). "Successful treatment of primary cardiac lymphoma with monoclonal CD20 antibody (rituximab)". Circ J. 68 (2): 172–3. doi:10.1253/circj.68.172. PMID 14745155.
  2. Seddon B, Strauss SJ, Whelan J, Leahy M, Woll PJ, Cowie F; et al. (2017). "Gemcitabine and docetaxel versus doxorubicin as first-line treatment in previously untreated advanced unresectable or metastatic soft-tissue sarcomas (GeDDiS): a randomised controlled phase 3 trial". Lancet Oncol. 18 (10): 1397–1410. doi:10.1016/S1470-2045(17)30622-8. PMC 5622179. PMID 28882536.
  3. 3.0 3.1 Schiff PB, Horwitz SB (1980). "Taxol stabilizes microtubules in mouse fibroblast cells". Proc Natl Acad Sci U S A. 77 (3): 1561–5. doi:10.1073/pnas.77.3.1561. PMC 348536. PMID 6103535.
  4. 4.0 4.1 Germano D, Daniele B (2014). "Systemic therapy of hepatocellular carcinoma: current status and future perspectives". World J Gastroenterol. 20 (12): 3087–99. doi:10.3748/wjg.v20.i12.3087. PMC 3964381. PMID 24696596.
  5. Keung EZ, Burgess M, Salazar R, Parra ER, Rodrigues-Canales J, Bolejack V; et al. (2020). "Correlative Analyses of the SARC028 Trial Reveal an Association Between Sarcoma-Associated Immune Infiltrate and Response to Pembrolizumab". Clin Cancer Res. 26 (6): 1258–1266. doi:10.1158/1078-0432.CCR-19-1824. PMC 7731262 Check |pmc= value (help). PMID 31900276.

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