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Identifying Dysregulated Genes Induced by Kaposi's Sarcoma-associated Herpesvirus (KSHV)
Published on: September 14, 2010
Epidemic Kaposi's sarcoma
R L Krigel1, A E Friedman-Kien
1Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111.
Abstract:
No significant impact of available treatments on survival among patients with epidemic KS has been demonstrated. Therefore, antitumor therapy now should be considered palliative. In the early stages of the disease, systemic treatment may not be needed, whereas advanced disease requires systemic treatment with one or more agents known to have antitumor activity. A complete therapeutic response is difficult to achieve and if such response is obtained, maintenance therapy may be necessary. The overall prognosis for survival in patients with epidemic KS appears to depend on the severity of immune suppression and HIV infection rather than on the neoplastic proliferation and tumor load. This is reflected in the new staging proposals for KS. Ultimately, the ideal treatment for the AIDS patient with KS will be a combination of antiretroviral therapy to suppress further effects of HIV, biological therapy to reverse the immunologic defects, chemotherapy to control tumor development, and hematopoietic growth factors to ameliorate treatment toxicities.
Insights
Current treatments offer limited survival benefits for epidemic Kaposi sarcoma (KS). Antitumor therapy is palliative, with prognosis depending on HIV/immune status, not tumor load.
Area of Science:
- Oncology
- Immunology
- Infectious Diseases
Background:
- Epidemic Kaposi sarcoma (KS) is an AIDS-defining malignancy.
- Current therapeutic options have shown limited impact on patient survival.
Purpose of the Study:
- To evaluate the efficacy of available treatments for epidemic Kaposi sarcoma.
- To define the prognostic factors influencing survival in patients with epidemic KS.
Main Methods:
- Review of existing treatment modalities for epidemic KS.
- Analysis of factors affecting patient prognosis, including immune suppression and HIV viral load.
Main Results:
- No significant impact of available treatments on survival has been demonstrated.
- Prognosis is primarily determined by the severity of immune suppression and HIV infection, not tumor burden.
- Complete therapeutic response is challenging, often necessitating maintenance therapy.
Conclusions:
- Antitumor therapy for epidemic KS should be considered palliative.
- Advanced disease requires systemic treatment with active agents.
- Future ideal treatment involves a combination of antiretroviral therapy, biological therapy, chemotherapy, and hematopoietic growth factors.
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