Liposomal daunorubicin: new preparation. Kaposi's sarcoma: occasional remission

Liposomal daunorubicin rarely leads to complete remission of the unsightly mucocutaneous lesions Kaposi's sarcoma. One trial comparing liposomal daunorubicin with the ABV protocol (doxorubicin + bleomycin + vincristine) showed no statistically significant difference between the treatments in terms of efficacy or overall tolerability. Liposomal daunorubicin caused less hair loss and neuropathy, both of which can affect these patients' quality of survival, but it was more likely to cause neutropenia, sometimes requiring the use of haematopoeitic growth factors. There is some evidence that the liposomal formulation reduces the cardiotoxicity of daunorubicin, but this has to be confirmed, especially in the long term. It is not known whether increasing the dose of daunorubicin leads to better clinical efficacy. However, patients who relapse when liposomal daunorubicin is withdrawn may receive the drug again, without observing a cumulative dose limit, provided that cardiac function remains normal on the basis of tests recommended in the approved summary of product characteristics.