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Taxol not working; what's next??
Sep 23, 2002

I'm being treated with Taxol as a second line of defense.the KS in my lungs is getting worse. Do I have any other options?

Response from Dr. Dezube

First it's important to know if you are on optimal HIV therapy. To get the maximum benefit from Taxol, you need to be on an HIV-regimen that will maximally decrease your viral load. Perhaps you are already taking such a regimen.

Sometimes you can get a little more benefit from Taxol by changing the way it's given. Optimally it should be given every two weeks (dose 100 mg/m2). Some oncologists give it weekly at a very low dose; this is also quite effective. So if you are getting it every 3 or 4 weeks, you might try a change in dosing schedule.

Other agents that work are etoposide and vinorelbine. Your oncologist would know about this agents. I am presuming you have at some time been treated with either Doxil or DaunoXome. These compounds have less side effects than Taxol and are typically used before Taxol. Have you had either Doxil or DaunoXome.

Lastly there are many KS clinical trials. Most of them occur in the major cities. You oncologist might hook you up to one of those centers.

It's a rare patient these days who develops KS which progresses on all known therapies.

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