Kaposi's sarcoma medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
The optimal therapy for Kaposi's sarcoma depends on multiple factors. Management strategies varies depending on the specific variant of Kaposi's sarcoma. Classic Kaposi's sarcoma management may range from no treatment to either radiotherapy, local therapeutic | The optimal therapy for Kaposi's sarcoma depends on multiple factors. Management strategies varies depending on the specific variant of Kaposi's sarcoma. Classic Kaposi's sarcoma management may range from no treatment to either [[radiotherapy]], local therapeutic interventions, or surgical excision. Iatrogenic Kaposi's sarcoma management focuses on modifying [[immunosuppressive therapy]] in addition to local therapeutic interventions. Endemic Kaposi's sarcoma is primarily manage by systemic [[chemotherapy]]. However, there is no curative treatment for epidemic Kaposi's sarcoma; the mainstay management is [[Highly active antiretroviral therapy|HAART therapy]] which aims for the palliation and control of Kaposi's sarcoma.<ref name="pmid22677687">{{cite journal| author=Fatahzadeh M| title=Kaposi sarcoma: review and medical management update. | journal=Oral Surg Oral Med Oral Pathol Oral Radiol | year= 2012 | volume= 113 | issue= 1 | pages= 2-16 | pmid=22677687 | doi=10.1016/j.tripleo.2011.05.011 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22677687 }} </ref><ref name="pmid24585567">{{cite journal| author=Masur H, Brooks JT, Benson CA, Holmes KK, Pau AK, Kaplan JE et al.| title=Prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: Updated Guidelines from the Centers for Disease Control and Prevention, National Institutes of Health, and HIV Medicine Association of the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2014 | volume= 58 | issue= 9 | pages= 1308-11 | pmid=24585567 | doi=10.1093/cid/ciu094 | pmc=PMC3982842 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24585567 }} </ref> | ||
==Medical Therapy== | ==Medical Therapy== | ||
* The optimal therapy for Kaposi's sarcoma depends on multiple factors which include:<ref name="pmid22677687">{{cite journal| author=Fatahzadeh M| title=Kaposi sarcoma: review and medical management update. | journal=Oral Surg Oral Med Oral Pathol Oral Radiol | year= 2012 | volume= 113 | issue= 1 | pages= 2-16 | pmid=22677687 | doi=10.1016/j.tripleo.2011.05.011 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22677687 }} </ref><ref name="pmid24585567">{{cite journal| author=Masur H, Brooks JT, Benson CA, Holmes KK, Pau AK, Kaplan JE et al.| title=Prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: Updated Guidelines from the Centers for Disease Control and Prevention, National Institutes of Health, and HIV Medicine Association of the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2014 | volume= 58 | issue= 9 | pages= 1308-11 | pmid=24585567 | doi=10.1093/cid/ciu094 | pmc=PMC3982842 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24585567 }} </ref> | * The optimal therapy for Kaposi's sarcoma depends on multiple factors which include:<ref name="pmid22677687">{{cite journal| author=Fatahzadeh M| title=Kaposi sarcoma: review and medical management update. | journal=Oral Surg Oral Med Oral Pathol Oral Radiol | year= 2012 | volume= 113 | issue= 1 | pages= 2-16 | pmid=22677687 | doi=10.1016/j.tripleo.2011.05.011 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22677687 }} </ref><ref name="pmid24585567">{{cite journal| author=Masur H, Brooks JT, Benson CA, Holmes KK, Pau AK, Kaplan JE et al.| title=Prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: Updated Guidelines from the Centers for Disease Control and Prevention, National Institutes of Health, and HIV Medicine Association of the Infectious Diseases Society of America. | journal=Clin Infect Dis | year= 2014 | volume= 58 | issue= 9 | pages= 1308-11 | pmid=24585567 | doi=10.1093/cid/ciu094 | pmc=PMC3982842 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24585567 }} </ref> | ||
:* The anatomical location of the tumor | :* The [[anatomy|anatomical]] location of the tumor | ||
:* The specific variant of Kaposi's sarcoma | :* The specific variant of Kaposi's sarcoma | ||
:* The rate of distribution and progression of Kaposi's sarcoma lesions | :* The rate of distribution and progression of Kaposi's sarcoma lesions | ||
:* The patients clinical presentation | :* The patients clinical presentation | ||
:* The efficacy and potential side | :* The efficacy and potential [[side effect]]s of therapy | ||
:* The presence or absence of HIV infection | :* The presence or absence of [[HIV]] [[infection]] | ||
:* The degree of immune suppression | :* The degree of [[immune]] suppression | ||
:* The presence of other comorbidities | :* The presence of other comorbidities | ||
:* The preference and prognosis of the patients | :* The preference and prognosis of the patients | ||
* Management strategies varies depending on the specific variant of Kaposi's sarcoma such as: | * Management strategies varies depending on the specific variant of Kaposi's sarcoma such as: | ||
:* Classic Kaposi's sarcoma managemenet may range from no treatment to either radiotherapy, local therapeutic interventions, or surgical excision. | :* Classic Kaposi's sarcoma managemenet may range from no treatment to either [[radiotherapy]], local therapeutic interventions, or [[surgery|surgical excision]]. | ||
:* Iatrogenic Kaposi's sarcoma management focuses on modifying immunosuppressive therapy in addition to local therapeutic interventions. | :* Iatrogenic Kaposi's sarcoma management focuses on modifying [[immunosuppressive therapy]] in addition to local therapeutic interventions. | ||
:* Endemic Kaposi's sarcoma is primarily manage by systemic chemotherapy | :* Endemic Kaposi's sarcoma is primarily manage by systemic [[chemotherapy]] | ||
:* There is no curative treatment for epidemic Kaposi's sarcoma; the mainstay management is HAART therapy which aims for the palliation and control of Kaposi's sarcoma progression. | :* There is no curative treatment for epidemic Kaposi's sarcoma; the mainstay management is [[Highly active antiretroviral therapy|HAART therapy]] which aims for the palliation and control of Kaposi's sarcoma progression. | ||
* '''Local/regional therapy recommended for the management of Kaposi's sarcoma patients may include:''' | * '''Local/regional therapy recommended for the management of Kaposi's sarcoma patients may include:''' | ||
:* Intralesional vinca-alkaloids, [[bleomycin]], and [[interferon-alpha]] | |||
:* Topical 0.1% [[alitretinoin]] | |||
:* [[Imiquimod]] cream | |||
:* Intralesional vinca-alkaloids, bleomycin, and interferon-alpha | |||
:* Topical 0.1% alitretinoin | |||
:* Imiquimod cream | |||
:* Radiotherapy | :* Radiotherapy | ||
:* Laser therapy | :* [[Laser therapy]] | ||
* '''HAART therapy regimens recommended for the management of Kaposi's sarcoma patients may include:''' | * '''HAART therapy regimens recommended for the management of Kaposi's sarcoma patients may include:''' | ||
| Line 41: | Line 37: | ||
* '''Chemotherapy regimens recommended for the management of Kaposi's sarcoma patients may include:''' | * '''Chemotherapy regimens recommended for the management of Kaposi's sarcoma patients may include:''' | ||
:* Liposomal anthracyclins | :* Liposomal anthracyclins | ||
:* Paclitaxel | :* [[Paclitaxel]] | ||
:* Oral etoposide | :* Oral [[etoposide]] | ||
:* Doxorubicin {{and}} bleomycin {{and}} vincristine | :* [[Doxorubicin]] {{and}} [[bleomycin]] {{and}} [[vincristine]] | ||
:* Doxorubicin {{and}} bleomycin {{and}} vinblastine | :* Doxorubicin {{and}} bleomycin {{and}} [[vinblastine]] | ||
* '''Immune modulators recommended for the management of Kaposi's sarcoma patients may include:''' | * '''Immune modulators recommended for the management of Kaposi's sarcoma patients may include:''' | ||
:* Interferon-alpha | :* [[Interferon-alpha]] | ||
* '''Targeted therapies recommended for the management of Kaposi's sarcoma patients may include:''' | * '''Targeted therapies recommended for the management of Kaposi's sarcoma patients may include:''' | ||
:* Antiherpes therapy | :* Antiherpes therapy | ||
:* Angiogenic inhibitors ( | :* Angiogenic inhibitors ([[thalidomide]]) | ||
:* VEGF inhibitors | :* VEGF inhibitors ([[bevacizumab]]) | ||
:* Tyrosine kinase inhibitors | :* Tyrosine kinase inhibitors ([[imatinib]]) | ||
:* Matrix metalloproteinases | :* Matrix metalloproteinases | ||
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[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
[[Category:Infectious Disease Project]] | [[Category:Infectious Disease Project]] | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Revision as of 19:23, 21 January 2016
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Kaposi's sarcoma Microchapters |
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Kaposi's sarcoma medical therapy On the Web |
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Risk calculators and risk factors for Kaposi's sarcoma medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]
Overview
The optimal therapy for Kaposi's sarcoma depends on multiple factors. Management strategies varies depending on the specific variant of Kaposi's sarcoma. Classic Kaposi's sarcoma management may range from no treatment to either radiotherapy, local therapeutic interventions, or surgical excision. Iatrogenic Kaposi's sarcoma management focuses on modifying immunosuppressive therapy in addition to local therapeutic interventions. Endemic Kaposi's sarcoma is primarily manage by systemic chemotherapy. However, there is no curative treatment for epidemic Kaposi's sarcoma; the mainstay management is HAART therapy which aims for the palliation and control of Kaposi's sarcoma.[1][2]
Medical Therapy
- The anatomical location of the tumor
- The specific variant of Kaposi's sarcoma
- The rate of distribution and progression of Kaposi's sarcoma lesions
- The patients clinical presentation
- The efficacy and potential side effects of therapy
- The presence or absence of HIV infection
- The degree of immune suppression
- The presence of other comorbidities
- The preference and prognosis of the patients
- Management strategies varies depending on the specific variant of Kaposi's sarcoma such as:
- Classic Kaposi's sarcoma managemenet may range from no treatment to either radiotherapy, local therapeutic interventions, or surgical excision.
- Iatrogenic Kaposi's sarcoma management focuses on modifying immunosuppressive therapy in addition to local therapeutic interventions.
- Endemic Kaposi's sarcoma is primarily manage by systemic chemotherapy
- There is no curative treatment for epidemic Kaposi's sarcoma; the mainstay management is HAART therapy which aims for the palliation and control of Kaposi's sarcoma progression.
- Local/regional therapy recommended for the management of Kaposi's sarcoma patients may include:
- Intralesional vinca-alkaloids, bleomycin, and interferon-alpha
- Topical 0.1% alitretinoin
- Imiquimod cream
- Radiotherapy
- Laser therapy
- HAART therapy regimens recommended for the management of Kaposi's sarcoma patients may include:
- Non nucleoside reverse transcriptase (NNRT)-based therapy
- Protease Inhibitor (PI)-based therapy
- Chemotherapy regimens recommended for the management of Kaposi's sarcoma patients may include:
- Liposomal anthracyclins
- Paclitaxel
- Oral etoposide
- Doxorubicin AND bleomycin AND vincristine
- Doxorubicin AND bleomycin AND vinblastine
- Immune modulators recommended for the management of Kaposi's sarcoma patients may include:
- Targeted therapies recommended for the management of Kaposi's sarcoma patients may include:
- Antiherpes therapy
- Angiogenic inhibitors (thalidomide)
- VEGF inhibitors (bevacizumab)
- Tyrosine kinase inhibitors (imatinib)
- Matrix metalloproteinases
References
- ↑ 1.0 1.1 Fatahzadeh M (2012). "Kaposi sarcoma: review and medical management update". Oral Surg Oral Med Oral Pathol Oral Radiol. 113 (1): 2–16. doi:10.1016/j.tripleo.2011.05.011. PMID 22677687.
- ↑ 2.0 2.1 Masur H, Brooks JT, Benson CA, Holmes KK, Pau AK, Kaplan JE; et al. (2014). "Prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: Updated Guidelines from the Centers for Disease Control and Prevention, National Institutes of Health, and HIV Medicine Association of the Infectious Diseases Society of America". Clin Infect Dis. 58 (9): 1308–11. doi:10.1093/cid/ciu094. PMC 3982842. PMID 24585567.