Molecularly targeted therapy for Kaposi's sarcoma in a kidney transplant patient: case report, "what worked and what did not"

Abstract

Background: Imatinib is a tyrosine-kinase inhibitor; for which there is limited information regarding its effects on AIDS Kaposi's sarcoma and none in patients with transplant-associated Kaposi's sarcoma. Sirolimus, an immunosuppressive drug used for kidney transplant, exhibits antiangiogenic activity related to impaired production of VEGF (vascular endothelial growth factor), clinical benefit has been reported in Kaposi's sarcoma associated with renal graft.

Pulmonary involvement in Kaposi sarcoma: correlation between imaging and pathology

“…KS is the most common tumor among patients with human immunodeficiency virus (HIV) infection, occurring predominantly in homosexual or bisexual men [ 6 , 7 ]. Also, an increasing number of reports describe KS as a complication of solid organ transplantation [ 1 , 5 , 8 , 9 ]. Pulmonary involvement generally occurs in severely immunosupressed patients who already have mucocutaneous or digestive involvement [ 6 ].…”

Efficiency of late conversion from mycophenolate mofetil to everolimus in kidney graft recipients with posttransplant malignancy

“…Таким образом, ИПС способны не только предупреждать развитие опухо-лей, но и обладают потенциальными возможностями тормозить их рост и метастазирование [63,64], а при некоторых новообразованиях (в том числе при сарко-ме Капоши) вызывают их регрессирование [65][66][67]. Несмотря на эффективность ИПС в профилактике посттрансплантационных онкологических осложне-ний, опыт применения этих иммуносупрессантов для лечения de novo посттрансплантационных опухолей ограничен единичными случаями (от 1 до 15 случаев) с непродолжительными сроками наблюдения [27][28][29][30][31]68]. В подавляющем большинстве описанных случа-ев ИПС применялись для лечения саркомы Капоши.…”

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

“…Dezube et al [35] in 2006, described the variety of cellular growth/angiogenic pathways associated with KS including vascular endothelial growth factor (VEGF), insulin-like growth factor, platelet-derived growth factor (PDGF), angiopoietin and matrix metalloproteases (MMPs) that are used by HHV-8, the KS herpesvirus. Based on the known pathways associated with KS, drugs like imatinib, sirolimus and topical halofuginone are being tested for the treatment of AIDS-KS, and that, along with thalidomide, might have an important role in the treatment of AIDS-KS in the future [35][36][37][38][39].…”