Phase I AIDS Clinical Trials Group (075) study of adriamycin, bleomycin and vincristine chemotherapy with zidovudine in the treatment of AIDS-related Kaposi's sarcoma.
OBJECTIVE
To determine the toxicity and maximum tolerated dose of doxorubicin (adriamycin) in combination with fixed doses of bleomycin, vincristine (ABV) and zidovudine in patients with advanced AIDS-related Kaposi's sarcoma.


METHODS
Twenty-six HIV-seropositive men with Kaposi's sarcoma were treated daily with 100 mg zidovudine orally every 4 h, along with combination chemotherapy using bleomycin 10 U/m2 and vincristine 1.4 mg/m2 (maximum, 2 mg) given intravenously in 2-week cycles. In addition, three successive cohorts of eight patients received escalating doses of doxorubicin each beginning with no doxorubicin (level I), doses of 10 mg/m2 (level II), and 15 mg/m2 (level III).


RESULTS
The major dose-limiting toxicity experienced with the combination therapy was severe neutropenia in eight patients, four of whom received level III doxorubicin (15 mg/m2). Therefore, 10 mg/m2 of doxorubicin in combination with zidovudine and BV chemotherapy was defined as the maximum tolerated dose. Other dose-limiting toxicities included neuropathy (n = 2), cutaneous toxicity associated with bleomycin (n = 1), and diarrhea (n = 1). Seventeen patients (71%; 95% confidence interval, 46-85) experienced either partial (n = 13) or clinical complete remission (n = 4) to therapy after a median of five cycles (range, 2-9).


CONCLUSIONS
The maximum tolerated dose of doxorubicin is 10 mg/m2 when given in combination with zidovudine and BV chemotherapy. Response rates observed with the combined antiretroviral and chemotherapy regimen are similar to those previously reported with ABV chemotherapy alone.
Gill
P S
PS
Department of Internal Medicine, University of Southern California School of Medicine, Los Angeles.
Miles
S A
SA
Mitsuyasu
R T
RT
Montgomery
T
T
McCarthy
S
S
Espina
B M
BM
Feldstein
M
M
Levine
A M
AM
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000276:immunology; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001761:Bleomycin / Q000008:administration & dosage; D001853:Bone Marrow / Q000187:drug effects; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D004361:Drug Tolerance; D006801:Humans; D008297:Male; D009503:Neutropenia / Q000139:chemically induced; D010292:Paresthesia / Q000139:chemically induced; D012514:Sarcoma, Kaposi / Q000188:drug therapy* / Q000209:etiology*; D014750:Vincristine / Q000008:administration & dosage; D015215:Zidovudine / Q000008:administration & dosage*
D001761:Bleomycin; D015215:Zidovudine; D014750:Vincristine; D004317:Doxorubicin