title: Retrospective analysis of the efficacy of gemcitabine for previously treated AIDS-associated Kaposi's sarcoma in western Kenya.
abstract: OBJECTIVE
  Evaluation of outcomes in the use of single-agent gemcitabine for the treatment of AIDS-associated Kaposi's sarcoma (KS) in a western Kenyan cancer treatment program.
  
  
  METHODS
  Retrospective chart review of all patients with KS treated with single agent gemcitabine following failure of first-line Adriamycin, bleomycin, and vincristine (ABV). Baseline demographics were collected, and clinicians' assessments of response were utilized to fill out objective criteria for both response as well as symptom benefit assessment.
  
  
  RESULTS
  Twenty-three patients with KS who had previously failed first-line therapy with ABV were evaluated. Following treatment, 22 of the 23 patients responded positively to treatment with stable disease or better. Of the 18 patients who had completed therapy, with a median follow-up of 5 months, 12 patients had no documented progression.
  
  
  CONCLUSIONS
  Treatment options in the resource-constrained setting are limited, both by financial constraints as well as the need to avoid myelotoxicity, which is associated with high morbidity in this treatment setting. This work shows that gemcitabine has promising activity in KS, with both objective responses and clinical benefit observed in this care setting. Gemcitabine as a single agent merits further investigation for AIDS-associated KS.
authors.affiliation: Indiana University School of Medicine, IU Simon Cancer Center, 535 Barnhill Drive, Indianapolis, IN 46202, USA. rstrothe@gmail.com
authors.forename: R Matthew
authors.initials: RM
authors.lastname: Strother
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Gregory
authors.forename: Sonak D
authors.initials: SD
authors.lastname: Pastakia
authors.forename: Pamela
authors.initials: P
authors.lastname: Were
authors.forename: Constance
authors.initials: C
authors.lastname: Tenge
authors.forename: Naftali
authors.initials: N
authors.lastname: Busakhala
authors.forename: Beatrice
authors.initials: B
authors.lastname: Jakait
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Schellhase
authors.forename: Alan G
authors.initials: AG
authors.lastname: Rosmarin
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Loehrer
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001761:Bleomycin / Q000627:therapeutic use; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007630:Kenya; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D012514:Sarcoma, Kaposi / Q000188:drug therapy* / Q000209:etiology; D017211:Treatment Failure; D016896:Treatment Outcome; D014747:Vinblastine / Q000627:therapeutic use; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D001761:Bleomycin; D014747:Vinblastine; D004317:Doxorubicin; D000093542:Gemcitabine