A review of the efficacy and outcomes studies of currently approved chemotherapy treatments for advanced AIDS-Kaposi's sarcoma

Abstract

a b s t r a c tBackground: Acquired Immune Deficiency Syndrome (AIDS)-related Kaposi's sarcoma (KS) is a rare aggressive tumor. The benefits of drug therapy are established by clinical trials but it has been a challenge to draw comparisons between the different advanced AIDS-KS pharmacotherapy available. This review aims to evaluate the currently approved chemotherapy drugs for the treatment of AIDS-related advanced KS as well as the economic burden and impact on the quality of life of patients. Material and methods: Relevant articles were identified through a systematic review of the literature via a search of the National Center for Biotechnology Information (NCBI) PubMed database and the Internet (clinicaltrials.gov) using relevant medical subject heading (MESH) terms. Results: A total of 7 phase II and 4 phase III trials of liposomal anthracyclines (liposomal doxorubicin [PLD] and/or liposomal daunorubicin [DNX]) were identified. An evaluation of the trials comparing PLD to a competitor showed statistical difference p;0.01. DNX phase III trials were also evaluated and showed no statistical differences (p = 0.64). For paclitaxel, 6 clinical trials were selected (5 phase II and 1 phase III); however heterogeneity was not evaluated. 4 cost-effectiveness studies were compared and 3 concluded that PLD is more cost-effective than the competitor. 4 quality of life studies were analyzed. Conclusion: AIDS-KS impacts the patient's life physical, emotional and economic well being. In this work we compared studies of liposomal anthracyclines, still; further research among all the approved drugs for KS is warranted to evaluate efficacy as well as its economic burden worldwide.

Optimization, in vitro cytotoxicity and penetration capability of deformable nanovesicles of paclitaxel for dermal chemotherapy in Kaposi sarcoma

“…Paclitaxel (PTX), one of the established anticancer agents with broad spectrum efficacy against AIDS-related kaposi sarcoma (KS), acts by inhibiting antiapoptotic activity and downregulating the Bcl-2 proto-oncogene, a gene which is highly expressed in the spindle cells and the blood vessels in KS patients. Spindle cells mostly present in the advanced stage of the KS lesions represent the most prominent histopathological feature of the advanced nodular stage of KS (Raimundo and Asche 2011). Several phase II studies have proved the safety and efficacy of PTX against spindle cells in patients suffering with AIDS-related KS (Dittmer et al 2012, Douglas et al 2010.…”