Department of Oncology, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milano, Italy.
UCL, Institute for Global Health, London, UK.
J Chemother. 2021 Sep;33(5):342-347. doi: 10.1080/1120009X.2021.1920248. Epub 2021 Jun 1.
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.
尽管引入了有效的联合抗逆转录病毒疗法（cART），艾滋病相关卡波西肉瘤（AIDS-KS）仍然是 HIV 阳性患者中最常见的恶性肿瘤。在晚期或进展形式中，联合 cART 的化疗（CT）是首选治疗方法。本研究的目的是评估聚乙二醇化脂质体多柔比星（PLD）作为 AIDS-KS 一线 CT 的疗效和耐受性。在这项单机构回顾性研究中，PLD（20mg/m2，每 2 周静脉注射一次，共 6 或 12 个周期）与 cART 联合用于高危和一些预后良好或局限性皮肤疾病的病例。评估了治疗的反应率和不良反应。我们共纳入了 33 例 AIDS-KS 患者：中位年龄 44 岁，男性 90.9%，白种人 72.7%，cART 初治（HIV 感染和 KS 同时诊断）84.4%，中位淋巴细胞 CD4+计数 134 个/μL，中位 HIV 病毒载量为 4.9log10 拷贝/ml。32 例患者被分配到预后不良的 KS 期。9 例患者出现 3-4 级毒性。未描述心血管事件或严重败血症。31 例可评估疗效的患者中，有 25 例报告完全缓解。中位随访 52 个月后，3 年无进展生存率为 68.6%。PLD 联合 cART 是一种有效、可行且耐受性良好的 AIDS-KS 晚期一线 CT。
