Weekly paclitaxel treatment in the first-line therapy of classic Kaposi sarcoma: A real-life study

Abstract

Kaposi sarcoma is an angioproliferative disease associated with human herpes virus 8 infection. Classic Kaposi sarcoma (CKS) usually develops in older age. Although CKS often does not require systemic therapy, systemic therapy can be administered in progressively symptomatic patients. In this real-life study, we purposed to determine effectiveness and safety of weekly paclitaxel therapy in the first-line treatment of CKS. In this cross-sectional retrospective study, we analyzed the clinical data of 44 patients with CKS who received first-line paclitaxel therapy between January 2000 and December 2020. Paclitaxel was administered by intravenous infusion 80 to 100 mg/weekly. The median age of the patients was 67 years (range, 39–86 years), and majority male (77.2%). All patients had cutaneous involvement in extremities. The median follow-up time from paclitaxel treatment was 39.1 (range, 3.7–173.5) months. The median progression free survival from start of therapy was 35.1 months (range, 2–144 months). Complete response, partial response and stable disease were observed in 7 (15.9%), 28 (63.7%) and 6 (13.6) patients, respectively. Objective control rate was 79.6%, and the median response time after the last dose of paclitaxel was 18.2 months. A total of 4 patients (9.1%) had grade 3 to 4 neutropenia, but it was not complicated by febrile neutropenia. Three patients (6.8%) experienced grade 3 to 4 peripheral neuropathy. No patient had grade 3 to 4 allergic reaction. There was no drug-related death. According to our results, paclitaxel is an effective therapy option with an acceptable safety profile for patients with advanced CKS.

Kaposi's sarcoma in a patient with pemphigus vulgaris mimicking exacerbation of pemphigus

“…Some recent therapeutic agents such as imatinib and matrix metalloproteinase inhibitors are also being tried 27 , 28 , 29 and some antiviral agents including ganciclovir, foscarnet, valganciclovir and cidofovir have been shown to have some therapeutic effects via inhibiting HHV‐8. 30 , 31 However, the best therapeutic approach for KS lesions in setting of PV is still remains to be elucidated. Although withdrawal of immunosuppressant agents seems to be the mainstay of management of these patients and could led to tumor regression in some cases, 32 this may not always be feasible due to intractable nature of pemphigus in some patients.…”

“…For extensive disease, a combination of surgery, chemotherapy and radiation is advocated. Some recent therapeutic agents such as imatinib and matrix metalloproteinase inhibitors are also being tried 27–29 and some antiviral agents including ganciclovir, foscarnet, valganciclovir and cidofovir have been shown to have some therapeutic effects via inhibiting HHV‐8 30,31 . However, the best therapeutic approach for KS lesions in setting of PV is still remains to be elucidated.…”

Efficacy and outcomes of systemic chemotherapy in posttransplant and immunosuppression associated Kaposi sarcoma: Twenty years experience of a tertiary cancer center

“…In the literature, there is no consensus on which chemotherapeutic agent should be chosen primarily for treating IKS. [4,5,7,19] The study by Brambilla et al [5] conducted in 2017, which is the most comprehensive study in the literature comparing OTR KS with non-OTR KS, included 143 patients (OTR: 33 individuals; non-OTR: 110 individuals). Corticosteroids and cyclosporine-A were identified as the most common IKS-related drugs.…”

“…In the literature, there is no consensus on which chemotherapeutic agent should be chosen primarily for treating IKS. [ 4 , 5 , 7 , 19 ]…”

Advancing Cancer Research: Current Knowledge on Cutaneous Neoplasia

“…In more extensive or symptomatic KS, systemic therapies are utilized [ 126 ]. Traditional chemotherapy agents, such as liposomal anthracyclines (e.g., liposomal doxorubicin), have shown efficacy in controlling disease progression.…”