Thalidomide in the Treatment of Kaposi’s Sarcoma

Abstract

Background: Kaposi’s sarcoma (KS) is a lymphangioproliferative tumour. Therapy of KS depends on the characteristics of the disease, especially area and growth rate of lesions, and patient condition. Currently symptomatic resectable lesions are excised, whereas more advanced disease and unresectable lesions are treated with radiotherapy. If a large area or internal organs are affected or other treatments fail, chemotherapy is used. Recently some authors have reported their encouraging experience in the use of thalidomide in patients with AIDS-related KS. Objective: To evaluate the efficacy of thalidomide in 3 patients with non-AIDS-related KS. Methods: Two patients with classic widespread cutaneous and 1 with iatrogenic cutaneous and visceral KS were treated with thalidomide (100 mg/day) for 12 months. Results: In all 3 patients partial remission was evident after 4 months of thalidomide therapy; in 2 out of 3 complete remission was achieved after 12 months of treatment. Conclusions: Our results seem to confirm the utility of thalidomide in the treatment of non-AIDS-related KS.

The management of children with Kaposi sarcoma in resource limited settings

“…In both HIV and non-HIV associated KS there is evidence that oral thalidomide at 3 mg/kg every evening for 4 months leads to a reduction in the number and size of skin nodules, reduces oedema and improves appetite and general wellbeing when measured by the Lansky score. It is given in the evening because it may make patients drowsy [32]. In Malawi, 49 HIV-infected ART-naive children with KS were given thalidomide for 4 months: 75% responded with tumour reduction and an improved Lansky score of whom 90% maintained a good response for 6 months [33].…”

Thalidomide in Kaposi Sarcoma: Promising or Disappointing?

“…Taken together, these results suggest that thalidomide is not a major therapy for KS, with a disappointing response rate and limitations due to side-effects, although it could be useful in some specific cases as shown by Rubegni et al [9] . However, an anti-angiogenic approach may still be interesting in KS, as suggested by Ben M'barek et al [10] .…”

“…retrospective studies [9,10] . In the first study, Rubegni et al [9] treated 3 patients with 100 mg/day of thalidomide for 1 year and observed a complete response in 2 patients (including an immunosuppressed patient with systemic KS) and a partial response in the third.…”

“…In the first study, Rubegni et al [9] treated 3 patients with 100 mg/day of thalidomide for 1 year and observed a complete response in 2 patients (including an immunosuppressed patient with systemic KS) and a partial response in the third. In the two responding cases, they observed a negativation of the HHV-8 viral load in the skin and the blood.…”

Angiogenesis in cutaneous disease: Part II

“…59,60 In a prospective, open-label, phase II clinical trial using imiquimod 5% cream to treat KS, eight of 17 patients showed clinical improvement of the lesions. 60 Rubegni et al 61 reported the treatment of three non-AIDS relatedeKS patients with thalidomide 100 mg/day. All experienced partial remission at 4 months, and two patients achieved complete remission at 12 months.…”