Treatment of HIV-associated Kaposi's Sarcoma with Pegylated Liposomal
Doxorubicin and HAART Produces Tumor Remission and CD4+ T Cell
Recovery
The combination of HAART and liposomal doxorubicin is a promising approach for the treatment of progressive HIV-related
Kaposi's sarcoma (KS). In the current study, researchers determined
the safety, tolerability, and efficacy of liposomal doxorubicin
and HAART as a combined treatment approach for advanced KS, and
assessed the impact of liposomal doxorubicin on HAART-mediated
immune
recovery and viral
suppression.
In an uncontrolled observational trial, KS treatment responses were
assessed in 54 HIV-1-infected patients with advanced KS according
to ACTG criteria.
Immunological and virological treatment responses were compared to
54 non-KS-affected HIV-1 patients who were individually matched
to the study participants according to sex, age (+/- 5 years),
CD4+ T cell count (+/- 25%), HIV RNA load (+/- 25%) and previous
antiretroviral therapy exposure.
Results
In 81.5% of the study
patients, complete or partial responses were observed within a
median of 8 weeks.
Treatment-related
side effects
were predominantly confined to leucopenia (44.4% of patients)
and mild-to-moderate liver enzyme elevation (22.3% of patients).
Relative CD4+ T cell
counts increased to a similar degree both in study patients and
matched pairs (7% vs 6%, respectively), yet, absolute CD4+ T cell
counts augmented considerably stronger in chemotherapy-naive matched
pairs than in the study patients.
The
authors conclude, “The simultaneous administration of HAART and
liposomal doxorubicin is a safe and effective treatment approach
for advanced KS and HAART-mediated recovery of relative CD4+ T
cell counts does not seem to be impaired by concomitant treatment
with liposomal doxorubicin.
Partners
AIDS Research Center, Massachusetts
General Hospital,
Boston, MA
02129, USA.
10/26/05
Reference
M Lichterfeld and others (German Clinical AIDS Working Group).
Treatment of HIV-1-Associated Kaposi’s Sarcoma with Pegylated
Liposomal Doxorubicin and HAART Simultaneously Induces Effective
Tumor Remission and CD4+ T Cell Recovery. Infection
33(3):140-147. June 2005.
