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Continuous infusion bleomycin in AIDS-related Kaposi's sarcoma
S C Remick1, M Reddy, D Herman
1Albany Medical College, NY 12208.
Summary
Continuous infusion bleomycin shows activity and acceptable toxicity for AIDS-related Kaposi's sarcoma. This treatment offers a promising option for advanced stages and potential salvage therapy.
Area of Science:
- Oncology
- Infectious Diseases
- Pharmacology
Background:
- AIDS-related Kaposi's sarcoma (AKS) is an opportunistic malignancy.
- Effective and tolerable treatments for AKS are crucial.
- Bleomycin is a chemotherapy agent with known activity against Kaposi's sarcoma.
Purpose of the Study:
- To evaluate the toxicity, response rate, and survival of patients with AKS treated with continuous infusion bleomycin.
- To determine the efficacy of a specific bleomycin dosing regimen in a patient population with advanced disease.
Main Methods:
- Seventeen patients with measurable AKS were treated with 72-hour continuous infusion bleomycin (20 mg/m2/d for 3 days every 3 weeks).
- Toxicity was assessed using National Cancer Institute common toxicity criteria.
- Response and survival were evaluated using Eastern Cooperative Oncology Group (ECOG) and AIDS Clinical Trials Group (ACTG) criteria.
Main Results:
- The regimen was generally well-tolerated, with low rates of severe toxicity (e.g., neutropenia, rash).
- Partial remission rates were 41% by ECOG criteria and 65% by ACTG criteria.
- Median survival was 7 months, with previously treated patients also showing response rates of 60%.
Conclusions:
- Continuous infusion bleomycin is an active treatment for advanced-stage AKS with acceptable toxicity.
- This regimen warrants further investigation in earlier-stage AKS and as a salvage therapy option.