Kaposi's sarcoma medical therapy
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Kaposi's sarcoma Microchapters |
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Overview
Patients with Kaposi's sarcoma have many treatment options. The selection depends on the stage of the tumor. The options are local therapy, radiation therapy, chemotherapy, biologic drugs treatment, or a combination of these methods. Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities. Because cancer treatments often damage healthy cells and tissues, side effects are common. Side effect may not be the same for each person, and they may change from one treatment session to the next.
Medical Therapy
- The optimal therapy for Kaposi's sarcoma depends on multiple factors which include:[1]
- 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
- ↑ 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.