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Randomized trial of paclitaxel versus pegylated liposomal doxorubicin for advanced human immunodeficiency virus-associated Kaposi sarcoma
Evidence of symptom palliation from chemotherapy
Version of Record online: 24 MAY 2010
Copyright © 2010 American Cancer Society
Volume 116, Issue 16, pages 3969–3977, 15 August 2010
How to Cite
Cianfrocca, M., Lee, S., Von Roenn, J., Tulpule, A., Dezube, B. J., Aboulafia, D. M., Ambinder, R. F., Lee, J. Y., Krown, S. E. and Sparano, J. A. (2010), Randomized trial of paclitaxel versus pegylated liposomal doxorubicin for advanced human immunodeficiency virus-associated Kaposi sarcoma. Cancer, 116: 3969–3977. doi: 10.1002/cncr.25362
- Issue online: 4 AUG 2010
- Version of Record online: 24 MAY 2010
- Manuscript Accepted: 5 MAR 2010
- Manuscript Revised: 24 FEB 2010
- Manuscript Received: 15 JAN 2010
- human immunodeficiency virus (HIV) infection;
- acquired immunodeficiency syndrome (AIDS);
- Kaposi sarcoma;
- pegylated liposomal doxorubicin
Paclitaxel and pegylated liposomal doxorubicin (PLD) are active cytotoxic agents for the treatment of human immunodeficiency virus (HIV)-associated Kaposi sarcoma (KS). A randomized trial comparing the efficacy and toxicity of paclitaxel and PLD was performed, and the effects of therapy on symptom palliation and quality of life were determined.
Patients with advanced HIV-associated KS were randomly assigned to receive paclitaxel at a dose of 100 mg/m2 intravenously (iv) every 2 weeks or PLD at a dose of 20 mg/m2 iv every 3 weeks. The KS Functional Assessment of HIV (FAHI) quality of life instrument was used before and after every other treatment cycle.
The study included 73 analyzable patients enrolled between 1998 and 2002, including 36 in the paclitaxel arm and 37 in the PLD arm; 73% of patients received highly active antiretroviral therapy (HAART) and 32% had an undetectable viral load (<400 copies/mL). Treatment was associated with significant improvements in pain (P = .024) and swelling (P < .001). Of the 36 patients who reported that pain interfered with their normal work or activities at baseline, 25 (69%) improved. Of the 41 patients who reported swelling at baseline, 38 (93%) improved. Comparing the paclitaxel and PLD arms revealed comparable response rates (56% vs 46%; P = .49), median progression-free survival (17.5 months vs 12.2 months; P = .66), and 2-year survival rates (79% vs 78%; P = .75), but somewhat more grade 3 to 5 toxicity for paclitaxel (84% vs 66%; P = .077).
Treatment with either paclitaxel or PLD appears to produce significant improvements in pain and swelling in patients with advanced, symptomatic, HIV-associated KS treated in the HAART era. Cancer 2010. © 2010 American Cancer Society.