Low-Dose Etoposide Effective Against High-Risk Kaposi's Sarcoma

U.S. researchers have discovered a "safe and effective" treatment for HIV patients with advanced Kaposi's sarcoma.

"Liposomal anthracyclines and paclitaxel are considered the best available cytotoxic therapies for Kaposi's sarcoma, but relapse is common," according to Scott R. Evans and colleagues at the Harvard School of Public Health and other institutions in Boston, New York City, and Chicago.

Evans and coauthors reported that a low-dose oral etoposide regimen stabilized or reversed the progression of the disease and improved quality of life for most patients in an early study. The researchers enrolled 36 patients with relapsed or progressive KS in a phase II study of the treatment. Participants took 50 mg doses of the antineoplastic agent daily on alternating weeks. Non-responding patients without severe treatment-induced toxicity received a dose escalation to 100 mg per day.

Study data recorded a 36.1 percent overall response rate, with one complete and 12 partial responses to etoposide therapy. Five of those who responded to the therapy did so after dose escalation. Evans and colleagues noted that the median time for a response was roughly 18 weeks, and responses lasted a median of 25 weeks.

Severe neutropenia and opportunistic infections were the most common side effects of etoposide therapy. The study, "Phase II Evaluation of Low-Dose Oral Etoposide for the Treatment of Relapsed or Progressive AIDS-Related Kaposi's Sarcoma: An AIDS Clinical Trials Group Clinical Study" appeared in the Journal of Clinical Oncology (2002;20(15)3236-3241).

"Low-dose oral etoposide at a dose of 50 mg/d is safe and effective for the treatment of refractory or progressed AIDS-related KS and has an overall positive effect on the quality of life of responding patients," Evans and coauthors concluded.

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