Pegylated liposomal doxorubicin plus highly active antiretroviral therapy versus highly active antiretroviral therapy alone in HIV patients with Kaposi's sarcoma

Abstract

Twenty-eight HIV patients either naive or failing highly active antiretroviral therapy (HAART)with moderate-advanced Kaposi's sarcoma (KS)were randomly chosen to initiate a new HAART regimen plus pegylated liposomal doxorubicin(PLD) or the new HAART regimen alone. After 48 weeks, better response rates were observed in the HAART plus PLD group (76% versus 20%). In HIV-infected patients with moderate-advanced KS, HAART alone may not be enough for KS response.

Squamous Cell Carcinoma of the Oral Cavity in Nonsmoking Women: A New and Unusual Complication of Chemotherapy for Recurrent Ovarian Cancer?

“…A high incidence of secondary malignancies with PLD use was also noted by Martin-Carbonero et al [9] in reviewing the long-term results of PLD treatment for patients with Kaposi's sarcoma: of the 29 deaths in that series, nine were a result of malignant disease. Seven deaths were a result of lymphoma, a known association because all patients were HIV ϩ .…”

“…The associated lower incidence of cardiotoxicity [8] makes it an attractive option for the treatment of patients with various malignancies that are considered sensitive to anthracyclines. PLD is approved for use in patients with Kaposi sarcoma [9], platinum-resistant recurrent ovarian cancer [10], and multiple myeloma. Recently, the combination of carboplatin and PLD was shown to lead to a longer progression-free survival interval in patients with platinum-sensitive recurrences, when compared with carboplatin and paclitaxel [11].…”

“…Its dose-limiting toxicity is usually dermatologic (palmar-plantar erythrodysesthesia) and, less commonly, stomatitis. The development of secondary malignancies, predominantly lymphomas but also including oral cavity SCC, has been recognized with PLD use for Kaposi sarcoma [9]. Because PLD is generally well tolerated, we deemed it suitable for long-term maintenance in patients treated using our protocols for recurrent ovarian cancer [10].…”

Squamous Cell Carcinoma of the Oral Tongue in Two Patients Previously Exposed to Long-Term Pegylated Liposomal Doxorubicin

“…Prolonged administration has shown a good safety profile [1][2][3]. Recently, concerns of a higher risk for oral cavity squamous cell carcinoma in patients with a history of prolonged exposure to PLD was reported [4,5].…”

“…Even though there has been an increasing incidence of non-AIDS-defining malignancies in the post-highly active antiretroviral therapy era, the incidence of cancers of the oral cavity in HIV patients is Ͻ1% [9]. Treatment of HIV-related Kaposi's sarcoma with PLD has been associated with squamous cell carcinoma of the tongue [2]. It was reported that three of 16 patients with ovarian cancer who were exposed to long-term PLD for a period Ն3 years developed oral cavity malignancies and one patient developed sublingual mucosal high-grade dysplasia [4,5].…”