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Pegylated liposomal doxorubicin as second-line therapy in the treatment of patients with advanced classic Kaposi sarcoma: a retrospective study.

AbstractBACKGROUND:
Classic Kaposi sarcoma (CKS) is a rare neoplasm that predominantly occurs in elderly subjects and has a variable clinical evolution. The clinical course is usually indolent, but occasionally the neoplasm progresses rapidly and spreads to internal organs, necessitating systemic chemotherapy. Because of the rarity of CKS, the best treatment has not been determined to date. To the authors' knowledge, few data exist regarding the use of pegylated liposomal doxorubicin (PLD) as first-line and second-line treatment in advanced CKS. The current retrospective study investigated the activity and toxicity of PLD in pretreated patients with aggressive, nonvisceral CKS.
METHODS:
Patients were treated with PLD at a dose of 20 mg/m(2) intravenously every 3 weeks until disease progression or the occurrence of intolerable side effects. Objective responses were determined after 3 and 6 cycles; toxicity was assessed every cycle. Secondary endpoints were pain intensity, progression-free survival, and overall survival.
RESULTS:
Twenty men with pretreated CKS (median age, 67 years) were treated with PLD. All patients received at least 6 cycles of therapy. Complete and partial responses were observed in 2 patients (10%) and 14 patients (70%), respectively. Neutropenia was the most significant grade 3 hematologic toxicity observed (evaluated according to the National Cancer Institute Common Toxicity Criteria for Adverse Events [version 3.0]), occurring in 20% of patients. Only 1 patient (5%) demonstrated grade 4 neutropenia. Fourteen patients (70%) achieved remission of pain and/or edema after 6 cycles. The median progression-free survival was 9 months (95% confidence interval, 5-13 months). At a median follow-up of 36 months, 15 patients (75%) remained alive.
CONCLUSIONS:
PLD is associated with an improvement in objective response and pain intensity and is well tolerated as a second-line treatment for CKS.
AuthorsGiuseppe Di Lorenzo, Rossella Di Trolio, Vincenzo Montesarchio, Giovanna Palmieri, Paola Nappa, Mario Delfino, Sabino De Placido, Bruce J Dezube
JournalCancer (Cancer) Vol. 112 Issue 5 Pg. 1147-52 (Mar 01 2008) ISSN: 0008-543X [Print] United States
PMID18098221 (Publication Type: Evaluation Study, Journal Article)
Chemical References
  • liposomal doxorubicin
  • Polyethylene Glycols
  • Doxorubicin
Topics
  • Aged
  • Disease-Free Survival
  • Doxorubicin (adverse effects, analogs & derivatives, therapeutic use)
  • Drug Administration Schedule
  • Drug Evaluation
  • Humans
  • Male
  • Polyethylene Glycols (adverse effects, therapeutic use)
  • Retrospective Studies
  • Sarcoma, Kaposi (drug therapy)
  • Skin Neoplasms (drug therapy)

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