Cardiac tumors medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dheeraj Makkar, M.D.[2]

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.
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. Docetaxel: MOA: Stabilizes microtubule assembly.
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. Other Vinca alkaloids block microtubule arrangement.
Prominent targeted therapy	Anti-angiogenic agents Pazopanib MOA suppression of the intracellular tyrosine kinase of VEGF receptor (VEGFR) and PDGF receptor (PDGFR) (PDGFR). Sorafenib MOA a potent soluble epoxide hydrolase inhibitor.
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.