Paclitaxel as first- or second-line treatment for HIV-negative Kaposi's sarcoma: a retrospective study of 58 patients

Background: Paclitaxel has recently been approved for AIDS-related Kaposi's sarcoma (KS) and there is much interest also in HIV-negative KS.Objective: To assess the safety and effectiveness of intravenous paclitaxel in the treatment of non-HIV-associated KS.Method: A retrospective database analysis of our departmental database in histologically proven, HIV-negative KS.Results: Fifty-eight patients treated with intravenous paclitaxel 100 mg weekly were identified. Among these patients, 11 patients underwent paclitaxel as first-line treatment, whereas 47 received paclitaxel after other types of systemic chemotherapy. Fifty-three (94.6%) patients achieved a partial or a complete remission after a mean of 13.5 infusions. Disease progression was observed in two patients and one patient had a stable disease. Thirty-one (58.5%) of 53 responding patients are still stable after a mean of 19.1 months of follow-up, while 22 (41.5%) patients relapsed after a mean of 14 months. Paclitaxel was repeated in relapsed patients obtaining PR/CR in all cases. Tolerance was good except for one patient who discontinued the treatment because of a severe allergic reaction.Conclusion: Paclitaxel is effective for the treatment of non-HIV-related KS, both as first- and as second-line treatment. It is well tolerated and can be repeated without loss of efficacy.