Paclitaxel effective for advanced AIDS-related Kaposi Sarcoma

Paclitaxel is an effective treatment for most patients with advanced AIDS-related Kaposi’s sarcoma (AIDS-KS) who have failed previous systemic chemotherapy, according to the results of a phase II study published in the 1 July issue of Cancer.

Few treatment options exist for patients with advanced AIDS-KS whose disease has progressed after receiving therapy with liposomal anthracyclines or combination chemotherapy, study author Dr. Parkash S. Gill, from the University of Southern California at Los Angeles, and colleagues note.

Dr. Gill’s team evaluated the safety and efficacy of paclitaxel in 107 male patients with advanced AIDS-KS who had failed at least one previous systemic chemotherapy regimen. The drug was given intravenously at a dose of 100 mg/m” over three hours, every two weeks.

Fifty-six percent of patients experienced a complete or partial response and the median duration of response was nearly nine months, the authors note. Almost half of the patients were taking a protease inhibitor at study entry, but the use of such agents had no bearing on the likelihood of achieving a response. Still, survival tended to be better when a protease inhibitor was used (p = 0.08).

In general, life-threatening side effects were uncommon. However, 35% of patients did experience life-threatening neutropenia and two patients died of associated sepsis, the researchers point out.

Treatment with paclitaxel was associated with a significant improvement in overall quality-of-life scores as well as improvements in KS-related symptom scores.

The present results indicate that “paclitaxel is a very active drug for this disease,” Dr. Gill told Reuters Health. “The FDA’s approval of paclitaxel for KS was actually based on data from the current study,” he added.

“Another drug that has been shown to be effective for AIDS-KS is pegylated liposomal doxorubicin (Doxil),” Dr. Gill noted. “Currently, there is a head-to-head study underway comparing paclitaxel with Doxil,” he said.