Paclitaxel in the treatment of patients with angiosarcoma of the scalp or face.

BACKGROUND: Angiosarcomas are rare tumors. Based on a complete response observed in a patient with angiosarcoma of the scalp treated with paclitaxel in a Phase II trial, the authors treated a cohort of patients with angiosarcoma of the scalp or face with paclitaxel as single agent. METHODS: The authors identified nine patients with angiosarcoma of the scalp or face treated at Memorial Sloan-Kettering Cancer Center with paclitaxel between January 1992 and December 1998. Various paclitaxel schedules were used over 1, 3, and 24 hours. RESULTS: Of the 9 patients, 8 had major responses (4 partial responses and 4 clinical complete responses) and 1 had a minor response, for a major response rate of 89%. The median duration of response was 5 months (range, 2-13 months). Neutropenia and peripheral neuropathy were the most frequent dose-limiting toxicities. No deaths were attributed to therapy. CONCLUSIONS: Paclitaxel as a single agent has substantial activity against angiosarcoma of the scalp or face, even in patients previously treated with chemotherapy or radiation therapy. Further investigation is warranted to define the optimal treatment dose and schedule.

Acute excisional wounds treated with a tissue-engineered skin (Apligraf).

BACKGROUND: Tissue-engineered products are usually composed of living cells and their supporting matrices that have been grown in vitro, using a combination of engineering and life sciences principles. Apligraf is a bilayered product composed of neonatal-derived dermal fibroblasts and keratinocytes, and Type I bovine collagen. OBJECTIVE: To evaluate in a prospective, multicentered open study, the effects of tissue therapy with a tissue-engineered skin (Apligraf) with partial or full-thickness excisional wounds. METHODS: One hundred and seven patients participated in this study. The tissue-engineered skin was applied once, immediately after excisional surgery, usually for skin cancer, and patients were followed for up to one year. RESULTS: The safety results were impressive, with no clinical or laboratory evidence of rejection. Clinically, graft persistence was good to excellent in 77 of 105 (73.3%) of patients at one week, falling to 56.6% and 53.6% at two weeks and one month respectively. CONCLUSION: To date, this is the largest experience with a tissue-engineered skin product in acute wounds, and this study suggests that tissue therapy may be safe and useful.