Phase I AIDS Clinical Trials Group (075) study of adriamycin, bleomycin and vincristine chemotherapy with zidovudine in the treatment of AIDS-related Kaposiʼs sarcoma

Gill, Parkash S.; Miles, Steven A.; Mitsuyasu, Ronald T.; Montgomery, Terri; Mccarthy, Suzie; Espina, Byron M.; Feldstein, Michael; Levine, Alexandra M.

doi:10.1097/00002030-199412000-00009

Cited by 36 publications

(5 citation statements)

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“…The majority of patients who developed anemia had received AZT. Anemia is the prominent toxicity of AZT therapy in HIV‐infected patients,30 and an overlapping bone marrow toxicity may occur when combining AZT with chemotherapy 8, 18, 29–31. In this setting, anemia is usually a later toxicity than leukopenia from combination therapy that includes AZT without colony stimulating factor support 31…”

Section: Discussionmentioning

confidence: 99%

Concomitant cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy plus highly active antiretroviral therapy in patients with human immunodeficiency virus-related, non-Hodgkin lymphoma

Vaccher

Spina

Gennaro

et al. 2001

Cancer

158

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BACKGROUND The feasibility and efficacy of concomitant chemotherapy and highly active antiretroviral therapy (HAART) is still unknown in patients with human immunodeficiency virus (HIV)‐related malignancies. To evaluate the impact of chemotherapy plus HAART on the clinical course of patients with HIV‐related, systemic, non‐Hodgkin lymphoma (HIV‐NHL), the authors compared retrospectively a group of 24 patients with HIV‐NHL who were treated with the cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy regimen plus HAART with a group of 80 patients who were treated with CHOP chemotherapy or a CHOP‐like regimen (i.e., cyclophosphamide, doxorubicin, teniposide, and prednisone with vincristine plus bleomycin) without receiving antiretroviral therapy. METHODS All patients were enrolled in two sequential trials performed at the Aviano Cancer Center, Italy, from April 1988 to December 1998. HAART was included with combination therapy from January 1997. Antiretroviral regimens consisted of two reverse transcriptase inhibitors and one protease inhibitor. RESULTS The two treatment groups were well matched with regard to patient demographics, NHL characteristics, HIV status, and treatment, i.e., the number of cycles and chemotherapy dose. The response rates were similar between the two groups. Severe anemia (Grade 3–4 according to the World Health Organization criteria) was significantly greater in the patients who received CHOP‐HAART compared with the patients who received CHOP alone (33% vs. 7%, respectively; P = 0.001). Leukopenia was similar between the two groups, but colony stimulating factor support was significantly greater in the CHOP‐HAART group than in the control group (92% vs. 66%, respectively; P = 0.03). Seventeen percent of CHOP‐HAART patients developed severe autonomic neurotoxicity, whereas none of the CHOP patients developed neurotoxicity (P = 0.002). At similar median follow‐up, opportunistic infection (OI) rates and mortality were significantly lower in the CHOP‐HAART patients than in the CHOP patients (18% vs. 52%, respectively; P = 0.05; and 38% vs. 85%, respectively; P = 0.001). The median survival for CHOP‐HAART patients was not reached, whereas the medial survival of CHOP patients was 7 months (P = 0.03). CONCLUSIONS The combination of CHOP plus HAART is feasible and may reduce the morbidity from OIs in HIV‐NHL patients. However, careful attention must be directed to cross toxicity and possible pharmacokinetic interactions between antiretroviral and antineoplastic drugs. The impact of the combined chemotherapy plus HAART treatment on patient survival needs urgently to be evaluated in prospective studies. Cancer 2001;91:155–63. © 2001 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Concomitant cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy plus highly active antiretroviral therapy in patients with human immunodeficiency virus-related, non-Hodgkin lymphoma

Vaccher

Spina

Gennaro

et al. 2001

Cancer

158

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“…[44][45][46] The most common application of vincristine is in combination with bleomycin (or bleomycin and doxorubicin) for treatment of multiple idiopathic hemorrhagic sarcoma (Kaposi' s sarcoma), a commonly diagnosed malignancy in patients with acquired immunodeficiency syndrome (AIDS). 47,48 In veterinary medicine, single agent vincristine sulfate chemotherapy has been used most effectively to attain remission of transmissible venereal tumors in dogs. 49 The drug is also used in combination with prednisone and cyclophosphamide or doxorubicin and cyclophosphamide to improve survival times in dogs with hematopoietic and lymphoid neoplasms.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of in vitro chemosensitivity of vaccine-associated feline sarcoma cell lines to vincristine and paclitaxel

Banerji¹,

Li²,

Klausner³

et al. 2002

ajvr

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Results of pharmacokinetic studies on vincristine and paclitaxel in other species suggest that concentrations greater than the IC50 values may be possible for both drugs in feline patients as well. The drug concentrations at which viable cell numbers were reduced by 90% may also be attained in vivo for some cases, but detailed information is needed regarding the distribution, concentration, duration of availability, and toxicity of various drugs in cats. Carefully chosen combinations of antineoplastic agents need to be screened to identify treatment protocols that may be further evaluated clinically for the treatment of VAFS.

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“…2,6 KS is not curable, and while some cases of acquired immunodeficiency syndrome (AIDS)-related KS respond to highly active antiretroviral therapy (HAART) or interferon alpha, long-term palliative cytotoxic therapy is often required. [7][8][9][10][11] However, cumulative toxicity can limit the ability to continue otherwise effective therapy. The development of less toxic patient self-administered long-term therapy would thus be an important therapeutic advance.…”

Section: Introductionmentioning

confidence: 99%

Activity of subcutaneous interleukin-12 in AIDS-related Kaposi sarcoma

Little

Pluda

Wyvill

et al. 2006

Blood

106

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Interleukin-12 (IL-12) enhances Th1-type T-cell responses and exerts antiangiogenic effects. We initiated a phase 1 pilot study of IL-12 in 32 patients with acquired immunodeficiency syndrome (AIDS)-related Kaposi sarcoma (KS) whose KS was progressing while on antiretroviral therapy. Fifteen patients had poor prognosis T 1 S 1 disease. IL-12 was administered subcutaneously twice weekly at doses from 100 to 625 ng/kg. The maximum tolerated dose was 500 ng/kg, and the principal toxicities were flulike symptoms, transaminase or bilirubin elevations, neutropenia, hemolytic anemia, and depression. No tumor responses were seen at the lowest dose (100 ng/kg), but 17 of 24 evaluable patients at the higher doses had partial or complete responses (response rate, 71%; 95% confidence interval, 48%-89%). Only 3 of 17 patients had a change in antiretroviral therapy before responding, and there were no significant differences between responders and nonresponders with regard to changes in CD4 counts or viral loads.Patients had increases in their serum IL-12, interferon-␥, and inducible protein-10 (IP-10) after the first dose, and increases above baseline persisted after week 4. These results provide preliminary evidence that IL-12 has substantial activity against AIDS-related KS with acceptable toxicity and warrants further investigation for this indication. (Blood. 2006; 107:4650-4657)

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Phase I AIDS Clinical Trials Group (075) study of adriamycin, bleomycin and vincristine chemotherapy with zidovudine in the treatment of AIDS-related Kaposiʼs sarcoma

Cited by 36 publications

References 0 publications

Concomitant cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy plus highly active antiretroviral therapy in patients with human immunodeficiency virus-related, non-Hodgkin lymphoma

Concomitant cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy plus highly active antiretroviral therapy in patients with human immunodeficiency virus-related, non-Hodgkin lymphoma

Evaluation of in vitro chemosensitivity of vaccine-associated feline sarcoma cell lines to vincristine and paclitaxel

Activity of subcutaneous interleukin-12 in AIDS-related Kaposi sarcoma

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