Abstract 79P
Background
Kaposi sarcoma (KS), associated with human herpesvirus 8 and often linked to HIV, poses therapeutic challenges, and may require cytotoxic chemotherapy in aggressive disease. While liposomal doxorubicin is commonly recommended as the preferred first-line chemotherapy, limited data compare its efficacy against paclitaxel. This study aimed to assess the effectiveness and safety of these agents in the first-line treatment of KS.
Methods
A single-center retrospective study in Brazil included 106 KS patients, 54 required systemic therapy and were included in the analysis. Treatment regimens comprised liposomal doxorubicin (50.9%), paclitaxel (35.8%), and other regimens (13.2%). Objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) served as endpoints. ORR was compared using Fisher’s exact test and time-to-event endpoints were estimated using the Kaplan-Meier method with Cox regression providing hazard ratios (HR) and 95% confidence intervals.
Results
Liposomal doxorubicin exhibited a higher ORR (74%) than paclitaxel (52.6%), though not statistically significant (p=0.2). Median PFS was not reached, with 5-year PFS at 64.4% for doxorubicin and 77% for paclitaxel (HR 0.63, p=0.51). Median OS was not reached, with 5-year OS at 70.6% for doxorubicin and 84% for paclitaxel (HR 0.44, p=0.31). Discontinuations due to toxicity were higher in the paclitaxel group (17.6%) compared to doxorubicin (7.4%). Among HIV-associated KS cases (40 patients), most initiated antiretroviral therapy < 3 months before chemotherapy, 40.5% had CD4 > 200, and 68.4% had a positive HIV viral load.
Conclusions
The proportion of KS patients requiring systemic treatment was low. Both liposomal doxorubicin and paclitaxel demonstrated a high ORR, favorable PFS, and OS. No statistically significant differences emerged between the two drugs, despite a numerically higher ORR with liposomal doxorubicin. This study suggests effective disease control with both agents in first-line treatment of KS. However, considering the retrospective nature and the relatively small sample size, caution is warranted in interpreting the findings.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.