Use of liposomal anthracyclines in Kaposi's sarcoma.
Conventional chemotherapy regimens for the treatment of advanced Kaposi's sarcoma (KS) show limited efficacy and considerable toxicity. Liposomal anthracyclines with potential utility in KS include pegylated liposomal doxorubicin (Doxil/Caelyx [PLD]), daunorubicin citrate liposome (DaunoXome [DNX]), and nonpegylated liposomal doxorubicin (Myocet [NPLD]). Preclinical data showed that pegylated liposomes accumulate preferentially in highly vascularized KS lesions. In randomized clinical trials, PLD induced higher response rates than did the conventional combination chemotherapy regimens, bleomycin + vincristine (BV) and BV + conventional doxorubicin (ABV); DNX produced a response rate comparable to that of ABV. NPLD has not been compared with conventional chemotherapy for KS. PLD and DNX were associated with less toxicity compared with BV or ABV, including less alopecia and fewer gastrointestinal and neurologic side effects. Grade 3/4 myelosuppression was common with both PLD and DNX; stomatitis and infusion reactions occurred with PLD treatment, but hand-foot syndrome was relatively infrequent in the dose schedules used for KS. Health-related quality of life was improved in several domains in patients treated with PLD or DNX compared with ABV.
Krown
Susan E
SE
Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Northfelt
Donald W
DW
Osoba
David
D
Stewart
J Simon
JS
D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003630:Daunorubicin / Q000008:administration & dosage*; D004317:Doxorubicin / Q000008:administration & dosage*; D006801:Humans; D008081:Liposomes; D011788:Quality of Life; D012514:Sarcoma, Kaposi / Q000188:drug therapy*
D000903:Antibiotics, Antineoplastic; D008081:Liposomes; D004317:Doxorubicin; D003630:Daunorubicin