Advertisement

Treatment of Kaposis Sarcoma

  • Jamie H. Von Roenn
  • Mary Cianfrocca
Part of the Cancer Treatment and Research book series (CTAR, volume 104)

Abstract

Kaposi’s sarcoma (KS) is the most common malignancy associated with human immunodeficiency virus-1 (HIV) infection.’ During the early years of the acquired immunodeficiency syndrome (AIDS) epidemic, KS was the presenting manifestation of AIDS in 10%-15% of HIV-infected homosexual men and 1%-2% of HIV-infected individuals from other risk categories.2Over the past decade, the proportion of individuals presenting with KS as their AID S-defining illness has declined. Data from the Multicenter AIDS Cohort Study (MACS), an observational study of homosexual and bisexual men, demonstrate an increase in the incidence of KS as an AIDS-defining event in the early 1990s followed by a decline in incidence in 1996-1997.3KS as a secondary AIDS diagnosis rose from 23% in the mid-1980s, to 42% in the early 1990s, to 50% in 1996-1997.3In recent years, the overall incidence of KS has decreased. A population based cancer surveillance study in Washington state observed a decrease in the average number of KS cases from 118 between 1990 and 1995 to 76 in 1996 and 21 in 1997.4

Keywords

Liposomal Doxorubicin Multicenter AIDS Cohort Study Liposomal Daunorubicin Liposomal Anthracyclines 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Lyter DW, Bryant J, Tackeray R, et al. Incidence of human immunodeficiency virus related and nonrelated malignancies in a large cohort of homosexual men. J Clin Oncol 13 (10): 2540–2546, 1995.PubMedGoogle Scholar
  2. 2.
    Centers for Disease Control: First 500,000 cases-United States, 1995. Morbid Mortal Weekly Rep 44:849–853, 1995.Google Scholar
  3. 3.
    Jacobson LP, et al. Impact of highly effective anti-retroviral therapy on the incidence of malignancies among HIV-infected individuals. The Second Natl AIDS Malignancy Conference (abstract) S5, 1998.Google Scholar
  4. 4.
    Wiggins CL, Aboulafia DM, Ryland LM, et al. Decline in HIV-associated Kaposi’s sarcoma (KS) and non-Hodgkin’s lymphoma (NHL) following the introduction of highly active antiretroviral therapy (HAART). The Third Natl AIDS Malignancy Conference (abstract) 21(1): A15, 1999.Google Scholar
  5. 5.
    Nichols CM, Fraitz CM, Hicks MJ. Treating Kaposi’s lesions in the HIV-infected patient. J Am Dent Assoc 124:78, 1993.PubMedGoogle Scholar
  6. 6.
    Huang L, Schnapp LM, Goodman PC, et al. Presentation of Pulmonary Kaposi’s sarcoma (abstract PB 110) in Programs and Abstracts of the 10thInternational Conference on AIDS. 171, 1994.Google Scholar
  7. 7.
    Niedt GW, Schinella A. Acquired immunodeficiency syndrome clinicopathologic study of 56 autopsies. Arch Pathol Lab Med 109:727–734, 1985.PubMedGoogle Scholar
  8. 8.
    Ioachim HL, Adsay V, Giancotti FR, et al. Kaposi’s sarcoma of internal organs. Cancer 75:1376–1385, 1995.PubMedCrossRefGoogle Scholar
  9. 9.
    Meduri GU, Stover DE, Lee M, et al. Pulmonary Kaposi’s sarcoma in the acquired immune deficiency syndrome. Am J Med 81:11–18, 1986.PubMedCrossRefGoogle Scholar
  10. 10.
    Judson MA, Sahn SA. Endobronchial lesions in HIV-infected individuals. Chest 105:1314, 1994.PubMedCrossRefGoogle Scholar
  11. 11.
    Lee VW, Fuller JD, O’Brien MJ, et al. Pulmonary Kaposi’s sarcoma in patients with AIDS: scintigraphic diagnosis with sequential thallium and gallium scanning. Radiology 80:409, 1991.Google Scholar
  12. 12.
    Krown SE, Metroka C, Wernz JC, et al. Kaposi’s sarcoma in the acquired immune deficiency syndrome: A proposal for uniform evaluation, response and staging criteria. J Clin Oncol 7(9):1201–1207, 1989.PubMedGoogle Scholar
  13. 13.
    Krown SE, Testa M, Huang J. AIDS-related Kaposi’s sarcoma: Prospective validation of the AIDS Clinical Trials Group staging classification: AIDS Clinical Trials Group Oncology Committee. J Clin Oncol 15(9):3085–3092, 1997.PubMedGoogle Scholar
  14. 14.
    Barillari G, Gendelman R, Gallo RC, et al. The tat protein of human immunodeficiency virus type 1, a growth factor for AIDS Kaposi’s sarcoma and cytokine-activated vascular cells, induces adhesion of the same cell types by using integrin receptors recognizing the RGD amino acid sequence. Proc Natl Acad Sci USA 90:7941, 1993.PubMedCrossRefGoogle Scholar
  15. 15.
    Mellors JW, Munoz A, Giorgi JV, et al. Plasma viral load and CD4+ lymphocytes as prognostic markers of HIV-1 infection. Ann Intern Med 126:946–954, 1997.PubMedGoogle Scholar
  16. 16.
    Olsen SJ, Moore PS. Kaposi’s sarcoma-associated herpesvirus (KSHV/HHV8) and the etiology of KS. in: Friedman H, Medveczky P, Bendinelli M, eds. Molecular immunology of herpesviruses. New York, NY: Plenum Publishing Corporation (in press).Google Scholar
  17. 17.
    Moore PS, Kingsley LA, Holmberg SP, Spira T, Gupta P, Hoover D, Parry JP, Conley LJ, Jaffe HW, Chang Y. Kaposi’s sarcoma-associated herpesvirus infection prior to onset of Kaposi’s sarcoma. AIDS 10:175–180, 1996.PubMedCrossRefGoogle Scholar
  18. 18.
    Looney DJ, Wikthe W, Feigal E, et al. Relationship of HHV-8 peripheral blood mononuclear cell burden to immunodeficiency, opportunistic infections, response to therapy and stage of Kaposi’s sarcoma. lstNatl AIDS Malignancy Conference, Bethesda, MD. J Acq Imm Def Syn 14(4):A35, 1997 (abstr 75).Google Scholar
  19. 19.
    Quinlevan B, Ye D, Wehkie R, et al. Frequency of HHV-8 detection in peripheral blood cells in patients with Kaposi’s sarcoma. 1stNatl AIDS Malignancy Conference, Bethesda, MD. J Acq Imm Def Syn 14(4):A22, 1997 (abstr 24).Google Scholar
  20. 20.
    Tamm M, Reichenberger F, McGandy C, Stalder A, Tietz A, Dalquen P, Perruchoud AP, Cathomas G Diagnosis of pulmonary Kaposi’s sarcoma by detection of human herpes virus 8 in bronchoalveolar lavage. Am J Respir Crit Care Med 157:458–63, 1997.Google Scholar
  21. 21.
    Feigal EG, Von Roenn JH, Justice K, et al. Kaposi’s sarcoma response criteria identified by the National Cancer Institute, food and Drug Administration and the AIDS Malignancy Consortium. 1stNatl AIDS Malignancy Conference, Bethesda, MD. J Acq Imm Def Syn 14(4):A22, 1997 (abstr 24).Google Scholar
  22. 22.
    Volm MD, Wernz J. Patients with advanced AIDS-related Kaposi’s sarcoma (EKS) no longer require systemic therapy after introduction of effective antiretroviral therapy. Proceedings of ASCO 16, 1997 (abstr 162).Google Scholar
  23. 23.
    Routy JP, Urbanek A, MacLeod J, et al. Significant regression of Kaposi’s sarcoma following initiation of an effective antiretroviral combination treatment. 1stNatl AIDS Malignancy Conference, Bethesda, MD. J Acq Imm Def Syn 14(4):A22, 1997 (abstr 23).Google Scholar
  24. 24.
    Flaitz CM, Nichols CM, Hicks MJ. Role of intralesional vinblastine administration in treatment of intraoral Kaposi’s sarcoma in AIDS. Eur J Cancer 31B(4):280–285, 1995.Google Scholar
  25. 25.
    Webster GF. Local therapy for mucocutaneous Kaposi’s sarcoma in patients with acquired immunodeficiency syndrome. Dermatol Surg 21:205–208, 1995.PubMedGoogle Scholar
  26. 26.
    Stelzer KJ, Griffin TW. A randomized prospective trial of radiation therapy for AIDS associated Kaposi’s sarcoma. Int J Radiat Oncol 27:1057–1061, 1993.CrossRefGoogle Scholar
  27. 27.
    Piedbois P, Frikha H, Martin L, et al. Radiotherapy in the management of epidemic Kaposi’s sarcoma. Int J Radiat Oncol 30(5):1207–1211, 1994.CrossRefGoogle Scholar
  28. 28.
    Swift PS. Radiation therapy in the management of HIV-related KS. Hematology/Oncology Clinics of North America 10(5): 1069–1080, 1996.PubMedCrossRefGoogle Scholar
  29. 29.
    Conant M. Topical Alitretinoin gel as treatment for cutaneous lesions of patients with AIDS-related Kaposi’s sarcoma: Results of two multi-center, double-blind, vehicle-controlled trials. 6thConf on Retroviruses and Opportunistic Infections, Chicago, IL, 1999 (abstr 205).Google Scholar
  30. 30.
    Ligand Pharmaceuticals Inc. Manufacturer’s package insert. February 1999.Google Scholar
  31. 31.
    Volberding PA, Mitsuyasu RT, Golando JP, et al. Treatment of Kaposi’s sarcoma with interferon alfa-2b (Intron A). Cancer 59:620–625, 1987.PubMedCrossRefGoogle Scholar
  32. 32.
    Mauss S, Jablonowski H. Efficacy, safety, and tolerance of low-dose, long-term interferon alpha-2b and zidovudine in early stage AIDS-associated Kaposi’s sarcoma. J Acq Imm Def Syn 10:157–162, 1995.Google Scholar
  33. 33.
    Fischl MA, Finkelstein DM, He W, et al. A phase II study of recombinant human interferon alpha-2b and zidovudine in patients with AIDS-related Kaposi’s sarcoma. J Acq Imm Def 11:379–385, 1996.Google Scholar
  34. 34.
    Shepherd FA, Beaulieu R, Gelmon K, et al. Prospective randomized trial of two dose levels of interferon alpha with zidovudine for the treatment of Kaposi’s sarcoma associated with human immunodeficiency virus infection: A Canadian HIV Clinical Trials Network Study. J Clin Oncol 16(5):1736–1742, 1998.PubMedGoogle Scholar
  35. 35.
    Paredes J, Kahn JO, Tong WP, et al. Weekly oral etoposide in patients with Kaposi’s sarcoma associated with human immunodeficiency virus infection: A phase 1 multicenter trial of the AIDS Clinical Trials Group. J Acq Imm Def Syn 9:138–144, 1995.Google Scholar
  36. 36.
    Volberding PA, Abrams DI, Conant M, et al. Vinblastine therapy for Kaposi’s sarcoma in the acquired immunodeficiency syndrome. Ann Int Med 103:335–338, 1985.PubMedGoogle Scholar
  37. 37.
    Mintzer DM, Real FX, Jovino L, et al. Treatment of Kaposi’s sarcoma and thrombocytopenia with vincristine in patients with acquired immune deficiency syndrome. Ann Int Med 102:200–202, 1985.PubMedGoogle Scholar
  38. 38.
    Caumes E, Guermonprez G, Katlama C, et al. AIDS-associated mucocutaneous Kaposi’s sarcoma treated with bleomycin. AIDS 6:1483–1487, 1992.PubMedCrossRefGoogle Scholar
  39. 39.
    Remick SC, Reddy M, Herman D, et al. Continuous infusion bleomycin in AIDS-related Kaposi’s sarcoma. J Clin Oncol 12:1130–1136, 1994.PubMedGoogle Scholar
  40. 40.
    Fischl MA, Krown SE, O’Boyle KP, et al. Weekly doxorubicin in the treatment of patients with AIDS-related Kaposi’s sarcoma. J Acq Imm Def Syn 6:259–264, 1993.Google Scholar
  41. 41.
    Saville MW, Lietzau J, Pluda JM, et al. Treatment of HIV-associated Kaposi’s sarcoma with paclitaxel. Lancet 346:26–28, 1995.PubMedCrossRefGoogle Scholar
  42. 42.
    Gill PS, Tulpule A, Espina BM, et al. Paclitaxel is safe and effective in the treatment of advanced AIDS-related Kaposi’s sarcoma. J Clin Oncol 17:1876–1883, 1997.Google Scholar
  43. 43.
    Bogner JR, Kronawitter U, Rolinski B, et al. Liposomal doxorubicin in the treatment of advanced AIDS-related Kaposi sarcoma. J Acq Imm Def Syn 7:463–468, 1994.Google Scholar
  44. 44.
    Harrison M, Tomlinson D, Stewart S. Liposomal-entrapped doxorubicin: An active agent in AIDS-related Kaposi’s sarcoma. J Clin Oncol 13:914–920, 1995.PubMedGoogle Scholar
  45. 45.
    Presant CA, Scolaro M, Kennedy P, et al. Liposomal daunorubicin treatment of HIV-associated Kaposi’s sarcoma. Lancet 341:1242–1243, 1993.PubMedCrossRefGoogle Scholar
  46. 46.
    Tulpule A, Yung RC, Wernz J, et al. Phase II trial of liposomal daunorubicin in the treatment of AIDS-related pulmonary Kaposi’s sarcoma. J Clin Oncol 16: 3369–374, 1998.Google Scholar
  47. 47.
    Gill PS, Rarick MU, Espina B, et al. Advanced acquired immunodeficiency syndrome-related Kaposi’s sarcoma: Results of pilot studies using combination chemotherapy. Cancer 65:1074–1078, 1990.PubMedCrossRefGoogle Scholar
  48. 48.
    Gill PS, Wernz J, Scadden DT, et al. Randomized phase III trial of liposomal daunorubicin versus doxorubicin, bleomycin and vincristine in AIDS related Kaposi’s sarcoma. J Clin Oncol 14:2353–2364, 1996.PubMedGoogle Scholar
  49. 49.
    Gill PS, Ravick MU, Bernstein-Singer M, et al. Treatment of advanced Kaposi’s sarcoma using a combination of bleomycin and vincristine. Ann J Clin Oncol 13:315319, 1990.Google Scholar
  50. 50.
    Kaplan L, Abrams D, Volberding P. Treatment of Kaposi’s sarcoma in acquired immunodeficiency syndrome with an alternating vincristine-vinblastine regimen. Cancer Treat Rep 70:1121–1122, 1986.PubMedGoogle Scholar
  51. 51.
    Laubenstein LJ, Krigel RL, Odajnyk CM, et al. Treatment of epidemic Kaposi’s sarcoma with etoposide or a combination of doxorubicin, bleomycin and vinblastine. J Clin Oncol 2:1115–1120, 1984.PubMedGoogle Scholar
  52. 52.
    Gompels MM, Hill A, Jenkins P, et al. Kaposi’s sarcoma in HIV infection treated with vincristine and bleomycin. AIDS 6:1175–1180, 1992.PubMedCrossRefGoogle Scholar
  53. 53.
    Sloand E, Kumar PN, Pierce PF. Chemotherapy for patients with pulmonary Kaposi’s sarcoma: benefit of filgrastim (G-CSF) in supporting dose administration. South Med J 86:1219–1224, 1993.PubMedCrossRefGoogle Scholar
  54. 54.
    Bakker PJM, Danner SA, Napel CH, et al. Treatment of poor prognosis epidemic Kaposi’s sarcoma with doxorubicin, bleomycin, vindesine and recombinant human granulocyte-monocyte colony stimulating factor (rh GM-CSF). Eur J Cancer 31A:188–192, 1995.PubMedCrossRefGoogle Scholar
  55. 55.
    Northfelt DW, Dezube B, Thommes JA, et al. Pegylated-liposomal doxorubicin versus doxorubicin, bleomycin and vincristine in the treatment of AIDS-related Kaposi’s sarcoma: Results of a randomized phase III clinical trial. J Clin Oncol 16:2445–2451, 1998.PubMedGoogle Scholar
  56. 56.
    Stewart JSW, Jabonowski H, Goebel FD, et al. Randomized comparative trial of pegylated liposomal doxorubicin versus bleomycin and vincristine in the treatment of AIDS-related Kaposi’s sarcoma. J Clin Oncol 16:683–691, 1998.PubMedGoogle Scholar
  57. 57.
    Mitsuyasu R, Von Roenn J, Krown S, et al. Comparison study of liposomal doxorubicin (DOX) alone or with bleomycin and vincristine (DBV) for treatment of advanced AIDS-associated Kaposi’s sarcoma (AIDS-KS): AIDS Clinical Trials Group (ACTG) protocol 286 (abstract) Proc Am Soc Clin Oncol 16:55a, 1997.Google Scholar
  58. 58.
    Gabizon A, Catane R, Uziely B. Prolonged circulation time and enhanced accumulation in malignant exudates of doxorubicin encapsulated in polyethylene-glycol coated liposomes. Cancer Res 54:987–992, 1994.PubMedGoogle Scholar
  59. 59.
    Ross M, Gill PS, Espina BM, et al. Liposomal daunorubicin (DaunoXome) in the treatment of advanced AIDS-related Kaposi’s sarcoma: Results of a phase II study (abstract PoB 3123). Int Conf AIDS 8:B107, 1992.Google Scholar
  60. 60.
    Berry G, Billingham M, Alderman E, et al. Reduced cardiotoxicity of Doxil (pegylated liposomal doxorubicin) in AIDS Kaposi’s sarcoma patients compared to a matched control group of cancer patients given doxorubicin. Proc Am Soc Clin Oncol (abst 843) 15:303, 1996.Google Scholar
  61. 61.
    Gordon KB, Tajuddin A, Guitart J, et al. Hand foot syndrome associated with liposome encapsulated doxorubicin therapy. Cancer 75(8):2169–2173, 1995.PubMedCrossRefGoogle Scholar
  62. 62.
    Dezube BJ, Von Roenn JH, Holden-Wiltse J, Cheung TW, et al. Fumagillin analog (TNP-470) in the treatment of Kaposi’s sarcoma: a phase I AIDS Clinical Trials Group trial. J Clin Oncol 16:1444–1449, 1998.PubMedGoogle Scholar
  63. 63.
    Fife K, Howard MR, Gracie F, Phillips RH, et al. Activity of thalidomide in AIDS-related Kaposi’s sarcoma and correlation with HHV8 titre. Intl J STD & AIDS 9:751–755, 1998.CrossRefGoogle Scholar
  64. 64.
    Gelsby MJ, Hoover DR, Weng S, et al. Use of antiherpes drugs and the risk of Kaposi’s sarcoma: Data from the Multicenter AIDS Cohort Study. AIDS 10:1101–1105, 1996.Google Scholar
  65. 65.
    Mocroft A, Youle M, Gazzard B, et al. Anti-herpesvirus treatment and risk of Kaposi’s sarcoma in HIV infection. Royal Free/Chelsea and Westminster Hospitals Collaborative Group. J Clin Investig 99:2082–2086, 1997.CrossRefGoogle Scholar
  66. 66.
    Kedes DH, Ganem D: Sensitivity of Kaposi’s sarcoma-associated herpesvirus replication to antiviral drugs. J Clin Investig 99:2082–2086, 1997.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2001

Authors and Affiliations

  • Jamie H. Von Roenn
    • 1
  • Mary Cianfrocca
    • 1
  1. 1.Fox Chase Cancer CenterRobert H. Lurie Comprehensive Cancer Center of Northwestern UniversityUSA

Personalised recommendations