This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gill, P. S. Articles by Scadden, D. T. Search for Related Content PubMed PubMed Citation Articles by Gill, P. S. Articles by Scadden, D. T. Social Bookmarking                            What's this?

Paclitaxel Is Safe and Effective in the Treatment of Advanced AIDS-Related Kaposi's Sarcoma

From the Departments of Medicine and Pharmacy, University of Southern California, Kenneth Norris Cancer Hospital and Research Institute, Los Angeles, CA; Bristol-Myers Squibb Pharmaceutical Research Institute, Wallingford, CT; Department of Medicine, Harvard University, New England Deaconess Hospital, Boston; and Massachusetts General Hospital, Boston, MA.

Address reprint requests to Parkash S. Gill, MD, Kenneth Norris Cancer Hospital and Research Institute, 1441 Eastlake Ave, MS-34, Los Angeles, CA 90033; email parkashg{at}hsc.usc.edu

PURPOSE: Liposomal anthracyclines are the present standard treatment for advanced AIDS-related Kaposi's sarcoma (KS). No effective therapies have been defined for use after treatment failure of these agents. A phase II trial was thus conducted with paclitaxel in patients with advanced KS to assess safety and antitumor activity.

MATERIALS AND METHODS: A regimen of paclitaxel at a dose of 100 mg/m² was given every 2 weeks to patients with advanced AIDS-related KS. Patients were treated until complete remission, disease progression, or unacceptable toxicity occurred.

RESULTS: Fifty-six patients with advanced AIDS-related KS were accrued. Tumor-associated edema was present in 70% of patients and visceral involvement in 45%. Forty patients (71%) had received prior systemic therapy; 31 of these were resistant to an anthracycline. The median entry CD4⁺ lymphocyte count was 20 cells/mm³ (range, 0 to 358). A median of 10 cycles (range, 1 to 54+) of paclitaxel was administered. Fifty-nine percent of patients showed complete (n = 1) or partial response (n = 32) to paclitaxel. The median duration of response was 10.4 months (range, 2.8 to 26.7+ months) and the median survival was 15.4 months. The main side effects of therapy were grade 3 or 4 neutropenia in 61% of patients and mild-to-moderate alopecia in 87%.

CONCLUSION: Paclitaxel at 100 mg/m² given every 2 weeks is active and well tolerated in the treatment of advanced and previously treated AIDS-related KS. The median duration of response is among the longest observed for any regimen or single agent reported for AIDS-related KS. Paclitaxel at this dosage and schedule is a treatment option for patients with advanced AIDS-related KS, including those who have experienced treatment failure of prior systemic therapy.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				L.-W. Qian, W. Greene, F. Ye, and S.-J. Gao Kaposi's Sarcoma-Associated Herpesvirus Disrupts Adherens Junctions and Increases Endothelial Permeability by Inducing Degradation of VE-Cadherin J. Virol., December 1, 2008; 82(23): 11902 - 11912. [Abstract] [Full Text] [PDF]

				J.-P. Spano, D. Costagliola, C. Katlama, N. Mounier, E. Oksenhendler, and D. Khayat AIDS-Related Malignancies: State of the Art and Therapeutic Challenges J. Clin. Oncol., October 10, 2008; 26(29): 4834 - 4842. [Abstract] [Full Text] [PDF]

				S. Y. Zafar, D. N. Howell, and J. P. Gockerman Malignancy After Solid Organ Transplantation: An Overview Oncologist, July 1, 2008; 13(7): 769 - 778. [Abstract] [Full Text] [PDF]

				K. M. Skubitz and D. R. D'Adamo Sarcoma Mayo Clin. Proc., November 1, 2007; 82(11): 1409 - 1432. [Abstract] [Full Text] [PDF]

				D. T. Scadden, V. V. Muse, and R. P. Hasserjian Case records of the Massachusetts General Hospital. Case 30-2006. A 41-year-old man with dyspnea, fever, and lymphadenopathy. N. Engl. J. Med., September 28, 2006; 355(13): 1358 - 1368. [Full Text] [PDF]

				T. J. Smith, J. Khatcheressian, G. H. Lyman, H. Ozer, J. O. Armitage, L. Balducci, C. L. Bennett, S. B. Cantor, J. Crawford, S. J. Cross, et al. 2006 Update of Recommendations for the Use of White Blood Cell Growth Factors: An Evidence-Based Clinical Practice Guideline J. Clin. Oncol., July 1, 2006; 24(19): 3187 - 3205. [Abstract] [Full Text] [PDF]

				R. F. Little, J. M. Pluda, K. M. Wyvill, I. R. Rodriguez-Chavez, G. Tosato, A. T. Catanzaro, S. M. Steinberg, and R. Yarchoan Activity of subcutaneous interleukin-12 in AIDS-related Kaposi sarcoma Blood, June 15, 2006; 107(12): 4650 - 4657. [Abstract] [Full Text] [PDF]

				M. C. Cheung, L. Pantanowitz, and B. J. Dezube AIDS-Related Malignancies: Emerging Challenges in the Era of Highly Active Antiretroviral Therapy Oncologist, June 1, 2005; 10(6): 412 - 426. [Abstract] [Full Text] [PDF]

				S. Okuno, W. J. Maples, M. R. Mahoney, T. Fitch, J. Stewart, P. M. Fracasso, M. Kraut, D. S. Ettinger, F. Dawkins, and C. Erlichman Evaluation of Epothilone B Analog in Advanced Soft Tissue Sarcoma: A Phase II Study of the Phase II Consortium J. Clin. Oncol., May 1, 2005; 23(13): 3069 - 3073. [Abstract] [Full Text] [PDF]

				J. Stebbing, A. Wildfire, S. Portsmouth, T. Powles, C. Thirlwell, P. Hewitt, M. Nelson, S. Patterson, S. Mandalia, F. Gotch, et al. Paclitaxel for anthracycline-resistant AIDS-related Kaposi's sarcoma: clinical and angiogenic correlations Ann. Onc., November 1, 2003; 14(11): 1660 - 1666. [Abstract] [Full Text] [PDF]

				D. M. Aboulafia, D. Norris, D. Henry, R. J. Grossman, J. Thommes, D. Bundow, R. C. Yocum, and V. Stevens 9-cis-Retinoic Acid Capsules in the Treatment of AIDS-Related Kaposi Sarcoma: Results of a Phase 2 Multicenter Clinical Trial Arch Dermatol, February 1, 2003; 139(2): 178 - 186. [Abstract] [Full Text] [PDF]

				R. Sarid, A. Klepfish, and A. Schattner Virology, Pathogenetic Mechanisms, and Associated Diseases of Kaposi Sarcoma-Associated Herpesvirus (Human Herpesvirus 8) Mayo Clin. Proc., September 1, 2002; 77(9): 941 - 949. [Abstract] [PDF]

				S. R. Evans, S. E. Krown, M. A. Testa, T. P. Cooley, and J. H. Von Roenn Phase II Evaluation of Low-Dose Oral Etoposide for the Treatment of Relapsed or Progressive AIDS-Related Kaposi's Sarcoma: An AIDS Clinical Trials Group Clinical Study J. Clin. Oncol., August 1, 2002; 20(15): 3236 - 3241. [Abstract] [Full Text] [PDF]

				F. Fata, A. Mirza, and A. Bernath Skin Lesions in Melanoma and Kaposi's Sarcoma: Case 3. Familial Classic Mediterranean Kaposi's Sarcoma J. Clin. Oncol., March 1, 2002; 20(5): 1415 - 1418. [Full Text] [PDF]

				E. Jonasch and F. G. Haluska Interferon in Oncological Practice: Review of Interferon Biology, Clinical Applications, and Toxicities Oncologist, February 1, 2001; 6(1): 34 - 55. [Abstract] [Full Text]

				B. J. Dezube AIDS-Related Kaposi Sarcoma: The Role of Local Therapy for a Systemic Disease Arch Dermatol, December 1, 2000; 136(12): 1554 - 1556. [Full Text] [PDF]

				K. Antman and Y. Chang Kaposi's Sarcoma N. Engl. J. Med., April 6, 2000; 342(14): 1027 - 1038. [Full Text] [PDF]

				D. M. Aboulafia The Epidemiologic, Pathologic, and Clinical Features of AIDS-Associated Pulmonary Kaposi’s Sarcoma Chest, April 1, 2000; 117(4): 1128 - 1145. [Abstract] [Full Text] [PDF]