Aversa Savina Maria Lucia, Cattelan Anna Maria, Salvagno Luigi, Crivellari Gino, Banna Giuseppe, Trevenzoli Marco, Chiarion-Sileni Vanna, Monfardini Silvio
Oncology Division, Azienda Ospedaliera di Padova, Via Gattamelata 64, 35218 Padova, Italy.
Crit Rev Oncol Hematol. 2005 Mar;53(3):253-65. doi: 10.1016/j.critrevonc.2004.10.009.
Although Kaposi's sarcoma (KS) has decreased in countries where the highly active antiretroviral therapy (HAART) regimen is available, however it remains, after non-Hodgkin's lymphomas, the most common malignancy in HIV+ patients. Advances in the treatment of AIDS-KS have been achieved, even though a gold standard therapy has not been yet defined. With the availability of HAART, a dramatic KS clinical response has been documented, making HAART essential in all patients. In case of aggressive and/or life threatening KS, more complex therapeutic schedules have to be taken into account, including chemotherapy and/or immunotherapy. Liposomal anthracyclines and paclitaxel have been approved by FDA as first line and second line mono-therapy, respectively. Interferon-alpha (INF-alpha) is the only immunomodulant agent to have shown a therapeutic effect. Among the new drugs, many antiangiogenetic agents have produced encouraging responses. Finally, the identification of the HHV-8 as a causative agent and new metalloproteinase inhibitors may offer promising targets for the KS treatment.
尽管在可获得高效抗逆转录病毒治疗(HAART)方案的国家,卡波西肉瘤(KS)的发病率有所下降,但它仍是继非霍奇金淋巴瘤之后,HIV阳性患者中最常见的恶性肿瘤。尽管尚未确定艾滋病相关卡波西肉瘤的金标准治疗方案,但在其治疗方面已取得进展。随着HAART的应用,已记录到显著的卡波西肉瘤临床反应,这使得HAART对所有患者都至关重要。对于侵袭性和/或危及生命的卡波西肉瘤,必须考虑更复杂的治疗方案,包括化疗和/或免疫治疗。脂质体蒽环类药物和紫杉醇已分别被美国食品药品监督管理局(FDA)批准为一线和二线单药治疗药物。α干扰素(INF-α)是唯一显示出治疗效果的免疫调节剂。在新药中,许多抗血管生成药物已产生令人鼓舞的反应。最后,将人类疱疹病毒8型(HHV-8)鉴定为病原体以及新型金属蛋白酶抑制剂可能为卡波西肉瘤的治疗提供有前景的靶点。