Weekly docetaxel is safe and effective in the treatment of advanced-stage acquired immunodeficiency syndrome-related Kaposi sarcoma

Authors

  • Soon Thye Lim M.D.,

    1. Department of Hematology, University of Southern California Keck School of Medicine/Norris Comprehensive Cancer Center, Los Angeles, California
    Current affiliation:
    1. Department of Medical Oncology, National Cancer Center of Singapore, 11 Hospital Drive, Singapore 169619, Singapore
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  • Anil Tupule M.D.,

    1. Department of Hematology, University of Southern California Keck School of Medicine/Norris Comprehensive Cancer Center, Los Angeles, California
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  • Byron M. Espina B.Sc.,

    1. Department of Hematology, University of Southern California Keck School of Medicine/Norris Comprehensive Cancer Center, Los Angeles, California
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  • Alexandra M. Levine M.D.

    Corresponding author
    1. Department of Hematology, University of Southern California Keck School of Medicine/Norris Comprehensive Cancer Center, Los Angeles, California
    • University of Southern California Keck School of Medicine/Norris Comprehensive Cancer Center, 1441 Eastlake Avenue, Los Angeles, CA 90033
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    • Fax: (323) 865 0060


Abstract

BACKGROUND

Intravenous paclitaxel, 100 mg/m2, given over 3 hours every 2 weeks is associated with a response rate of 59% in patients with recurrent or refractory acquired immunodeficiency syndrome (AIDS)-related Kaposi sarcoma (KS). However, this regimen is associated with significant myelosuppression, and the inconvenience of a 3-hour infusion. Moreover, no effective therapies have been defined for use after treatment failure with this agent. A Phase II trial was conducted with weekly docetaxel in patients with advanced-stage KS to assess safety and antitumor activity.

METHODS

Docetaxel was administered at a dose of 25 mg/m2 intravenously over 15–30 minutes weekly for 8 weeks. Thereafter, if the patient experienced stable disease or better response, treatment doses were given every other week until complete disease remission, disease progression, or unacceptable toxicity occurred.

RESULTS

Twelve patients were accrued—9 had > 25 mucocutaneous lesions, 1 had lymphedema, and 2 had visceral involvement. Ten patients (83%) had previous systemic chemotherapy, including 4 who received previous paclitaxel. Treatment was well tolerated, with no Grade 4 toxicity of any type. Grade 3 neutropenia occurred in 33% of patients but no patient had neutropenic fever. Five patients (42%) achieved a partial response, including 1 who had previously failed to respond to paclitaxel. The median time to disease progression was 26 months (range, 5–53 months). With a median follow-up period of 45 months, the median survival point had not been reached.

CONCLUSIONS

Weekly docetaxel is safe, with reasonable antitumor activity in patients with advanced-stage, recurrent, or refractory AIDS-related KS. Cancer 2005. © 2004 American Cancer Society.

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