Gastrointestinal and cutaneous AIDS-related Kaposi's sarcoma: Different activity of liposomal doxorubicin according to location of lesions

Abstract

9030 Background: Kaposi's sarcoma (KS) continuous being a frequent neoplasm in third world AIDS patients. Liposomal doxorubicin (LD) is the drug of choice for advanced KS; nevertheless, it is very expensive for third world countries. In addition, we believe that the greatest usefulness of LD is in patients with visceral KS and that there is a different activity of the drug according to the location of the lesions. Due to this, we carried out a prospective study to evaluate the effectiveness of LD in gastrointestinal KS patients as well as its differential clinical activity, depending on the location of the lesions. Methods: The study included thirteen AIDS male patients with ages between 25 and 35 years (mean: 27 years), a performance status > 70, with more than 25 cutaneous lesions and extensive gastrointestinal KS. They were treated with LD, 20 mg/m2 every 21 days, during 6 cycles, and half of them were under highly active antiretroviral therapy. Results: Ten patients (77%) were able to obtain a complete response of the gastrointestinal KS lesions and three (23%) a partial response. Regarding the cutaneous lesions, there was only one patient (8%) who showed a complete response, five (38%) showed partial responses and seven (54%) stabilized their disease. By applying Fisher's test we found a significant difference (p< 0.00035) when comparing the effectiveness of LD in gastrointestinal lesions in relation to cutaneous ones. Conclusions: It can be concluded that LD has a different activity in KS lesions, being more effective in gastrointestinal KS, which is very relevant since gastrointestinal KS can compromise the life of patients due to the massive bleeding risk. Due to this, we can recommend LD in patients from third world countries with extensive gastrointestinal KS. No significant financial relationships to disclose.