Source: Urology  |  Posted 5 years ago

By Louise Gagnon

TORONTO, CANADA -- August 16, 2006 -- A short course of chemotherapy and antiretroviral therapy appears to be adequate for treating most patients with Kaposi's sarcoma, according to retrospective research presented here.

"We wanted to see if our management of patients who had Kaposi's sarcoma is effective," said Libby Ratcliffe, MD, a fellow in infectious diseases at the North Manchester General Hospital in Manchester, United Kingdom.

"Kaposi's sarcoma is 1 of the AIDS-defining illnesses, and we are still seeing patients presenting with it. In particular, we have a seen a new cohort of patients who have immigrated from sub-Saharan Africa and present to us with it," she explained.

Research presented at the 13[^]th[] Conference on Retroviruses and Opportunistic Infections found that a short course of chemotherapy in addition to antiretroviral therapies was efficacious in treating Kaposi's sarcoma, Dr. Ratcliffe noted during his presentation at the 16[^]th[] International AIDS Conference (AIDS 2006) here on August 15[^]th[].

The chart review covered all cases of Kaposi's sarcoma at a single center from January 2000 through January 2006. Investigators stratified patients according to the stage of their illness. They looked at measures such as time from appearance of symptoms to diagnosis and event-free survival. They also looked at HIV-related measurements such as CD4, viral load, and use of highly active antiretroviral therapy (HAART)

A total of 26 patients were included in the review; 81% were male; 77% were white; the median age was 38 years. The appearance of Kaposi's sarcoma was the indicator for HIV in 28% of subjects. In more than 60%, the lag time between appearance and diagnosis was less than 3 months.

The median baseline CD4 cell count was 160, with the range being 18 to 650. Patients were put on HAART if they were not already on antiretroviral therapy when they presented. Currently, 85% of patients have undetectable viral load levels (< 50 copies/mL).

A total of 23 patients received liposomal doxorubicin as their chemotherapy and 65% currently have their disease in remission after receiving a mean of 5.5 doses of chemotherapy (range 2 to 9 doses). Mean duration of follow-up is 14.6 months (range 2-26 months). Eight patients relapsed (35%) and were administered doxorubicin or paclitaxel. Five of the patients are receiving a maintenance dose of chemotherapy.

"It appears that a short course of chemotherapy and antiretroviral therapy is adequate in treating most patients with Kaposi's sarcoma," said Dr. Ratcliffe. "Some patients may need a second line of chemotherapy."

She noted that the study's findings are limited by the fact that the analysis was retrospective, and there were no controls enrolled in the study.

[Presentation title: Improved Prognosis in the Treatment of Kaposi's Sarcoma Post-HAART. Poster TUPE0045]