Pegylated liposomal doxorubicin as first line treatment in aids-related Kaposi’s sarcoma: a real-life study

Abstract

Despite the introduction of effective combination antiretroviral therapy (cART) AIDS–related Kaposi Sarcoma (AIDS-KS) remains the most common malignancy in HIV positive patients. In advanced stage or progressive forms, chemotherapy (CT) in combination with cART is the treatment of choice. The aim of the study is to evaluate efficacy and tolerability of Pegylated Liposomal Doxorubicin (PLD) as first line CT in AIDS-KS. In this single institution retrospective study PLD (20 mg/m2 IV every 2 weeks for 6 or 12 cycles) in combination with cART was administered in poor risk and some cases of good prognosis or limited cutaneous disease. Response rate and adverse events to treatment was evaluated. We enrolled 33 patients with AIDS-KS: median age 44ys, male 90.9%, Caucasian 72.7%, cART-naïve (simultaneous diagnosis of HIV infection and KS) 84.4%, median lymphocyte CD4+ count 134cells, median HIV viral load 4.9 log10 copies/ml. 32 patients were assigned to a Poor Risk KS stage. Grade 3-4 toxicity was reported in 9 patients. No cardiovascular events or severe sepsis were described. Complete response was reported in 25 of 31 patients evaluable for efficacy. After a median follow-up of 52 months the 3-years PFS was 68.6%. PLD associated with cART is an effective, feasible and well tolerated first-line CT in advanced AIDS-KS.

Keywords:

• Kaposi Sarcoma
• Advanced stage
• AIDS
• HIV
• Combination antiretroviral therapy (cART)
• Pegylated Liposomal Doxorubicin

Disclosure statement

The author Nicla La Verde declare the following financial interests/personal relationships which may be considered as potential competing interests: grants from EISAI; speaker bureau, travel expences for conference from ROCHE, GENTILI; advisory role from NOVARTIS and CELGENE; advisor role, travel expences for conference from PFIZER; advisory board from MSD.

Additional information

Notes on contributors

Davide Dalu

Davide Dalu is a Medical Oncologist at the Luigi Sacco Hospital in Milan, Italy. His main areas of interest are: neoplasms in HIV positive patients, lymphoproliferative disorders and Head & Neck tumors.

Cinzia Fasola

Cinzia Fasola is a Medical Oncologist at the Luigi Sacco Hospital in Milan, Italy. Her main areas of interest are: neoplasms in HIV positive patients, lymphoproliferative disorders and Head & Neck tumors.

Luca Ammoni

Luca Ammoni is a resident of Oncology of University of Milan.

Davide De Francesco

Davide De Francesco is a Statistician. He earned his PhD at University College London. He is currently a Postdoctoral Researcher in Machine Learning and AI at Stanford University (CA, USA).

Maria Silvia Cona

Maria Silvia Cona is a Medical Oncologist at the Luigi Sacco Hospital in Milan, Italy. Her main areas of interest are: breast and urogenital tumours.

Selene Rota

Selene Rota is a Medical Oncologist at the Luigi Sacco Hospital in Milan, Italy. Her main area of interest is breast cancer.

Sabrina Ferrario

Sabrina Ferrario is a Medical Oncologist at the Luigi Sacco Hospital in Milan, Italy. Her main area of interest is gastro-intestinal tumours.

Anna Gambaro

Anna Gambaro is a Medical Oncologist at the Luigi Sacco Hospital in Milan, Italy. Her main area of interest is breast cancer

Nicoletta Tosca

Nicoletta Tosca is a Medical Oncologist at the Luigi Sacco Hospital in Milan, Italy. Her main areas of interest are: gynecologic and urogenital tumours.

Sheila Piva

Sheila Piva is a Medical Oncologist at the Luigi Sacco Hospital in Milan, Italy. Her main area of interest is lung cancer.

Nicla La Verde

Nicla La Verde is Director of the Departement of Oncology at the Luigi Sacco Hospital in Milan, Italy. Her main areas of interest are: gynecologic and breast tumours. She's a member of the national board of AIOM (Associazione Italiana Oncologia Medica).