Kaposi's sarcoma medical therapy
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Kaposi's sarcoma Microchapters |
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Kaposi's sarcoma medical therapy On the Web |
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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 degree of host immune competence
- 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:
- Surgical excision
- Cryotherapy
- Sclerotherapy
- 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:
- Interferon-alpha
- Targeted therapies recommended for the management of Kaposi's sarcoma patients may include:
- Antiherpes therapy
- Angiogenic inhibitors (e.g., thalidomide)
- VEGF inhibitors
- Tyrosine kinase inhibitors
- 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.