MOUNTAIN VIEW, California-Pegylated liposomal doxorubicin (Doxil, Caelyx) offered a sustained clinical benefit to 37% of patients with AIDS-related Kaposi’s sarcoma vs 16% of patients treated with liposomal daunorubicin (DaunoXome) in a randomized trial comparing the two drugs (ASCO abstract 1640).
A new study conducted by researchers at the Mayo Clinic shows that samarium-153 lexidronam (Quadramet), approved by the US Food and Drug Administration (FDA) in 1997 for the treatment of pain in patients with metastatic bone lesions, can be used at higher doses to treat osteosarcoma. The results of the study were published recently in the Journal of Clinical Oncology (20:189-196, 2002).
A dramatic spike in the incidence of Kaposi’s sarcoma (KS) in never-married men in New York and California in 1981 was one of the first indications of a new disease now known as acquired immunodeficiency syndrome (AIDS). We now appreciate a number of mechanisms by which human immunodeficiency virus (HIV) infection contributes to the pathogenesis of these tumors. The article by Drs. Gates and Kaplan provides an excellent review of changes in the epidemiology, presentation, and treatment of these tumors since the development of potent combination anti-HIV therapy.
CHICAGO-For many years, researchers have known that individuals who are seropositive for the human immunodeficiency virus (HIV) are at much greater risk of developing two forms of cancer-Kaposi’s sarcoma and non-Hodgkin’s lymphoma.
The association between HIV infection and the development of cancer was noted early in the acquired immunodeficiency syndrome (AIDS) epidemic. The AIDS-defining malignancies are Kaposi’s sarcoma, intermediate- or high-grade B-cell non-Hodgkin’s lymphoma (NHL), and cervical cancer. All of these cancers feature specific infectious agents in their etiology. These agents are human herpesvirus 8/Kaposi’s sarcoma-associated herpesvirus, or HHV-8/KSHV (implicated in Kaposi’s sarcoma), Epstein-Barr virus, or EBV (in primary central nervous system lymphoma and a subset of systemic B-cell NHL) and human papillomavirus, or HPV (in cervical cancer).[1]
Thalidomide (Thalomid) is recognized to have antiangiogenic properties and has been shown to be effective in the treatment of refractory myeloma.[1] As a result, thalidomide is now being investigated for use in a number of malignancies, including breast,
SEATTLE-A new study shows that human herpesvirus 8 (HHV-8), thought to be the cause of Kaposi’s sarcoma, is more likely to be found in mucosal samples than in anal/genital samples, and is found at higher levels in saliva than in samples from the genital tract. Consequently, viral spread is more likely from oral than from genital exposure.
At the end of its session, Congress passed a children’s health bill (H.R. 4365) that established a variety of new health programs. One section of the bill authorizes the CDC to study environmental and other risk factors for childhood cancers,
Soft-tissue sarcomas comprise approximately 7% of all pediatric malignancies. Surgery, chemotherapy, and radiation therapy have significantly improved survival.
The management of pediatric soft-tissue sarcomas has improved drastically through the use of multimodal therapy. These tumors include rhabdomyosarcomas and nonrhabdomyosarcomas. Both are staged using
The management of pediatric soft-tissue sarcomas has improved drastically through the use of multimodal therapy. These tumors include rhabdomyosarcomas and nonrhabdomyosarcomas. Both are staged using
In his excellent review, Dr. Mitsuyasu correctly highlights the three most important ingredients that play a role in the pathogenesis of acquired immunodeficiency syndrome (AIDS)-related Kaposi’s sarcoma (KS)-Kaposi’s sarcoma herpesvirus/human herpesvirus type 8 (KSHV/HHV-8); altered expression and response to cytokines; and stimulation of KS growth by the human immunodeficiency virus (HIV)-1 trans-activating protein, Tat. Recent studies have provided tremendous insight into the process whereby KSHV/HHV-8 creates the inflammatory-angiogenic state that characterizes KS.
Dr. Mitsuyasu has been doing clinical research in patients with AIDS-related Kaposi’s sarcoma (KS) since the beginning of the AIDS epidemic, and his review reflects this breadth of experience. It provides a well-rounded and up-to-date assessment of the pathophysiology, evaluation, and treatment of AIDS-related KS that should be a useful guide for practicing physicians.
In his article, Dr. Mitsuyasu concisely reviews a large body of data concerning the etiology, pathogenesis, epidemiology, and treatment of Kaposi’s sarcoma (KS) in the setting of the human immunodeficiency virus (HIV) infection. As he correctly points out, effective highly active antiretroviral therapy (HAART), with its consequent improvements in immune function and decrease in production of viral and cytokine cofactors that promote KS growth, has been partly responsible for the decline of KS incidence in areas with ready access to HIV therapy.
The criteria for successfully resecting pulmonary metastasis have not changed since they were originally described by Ehrenhaft in 1958.[1] They are (1) that the primary tumor site has been removed without evidence of local recurrence, (2) that no extrathoracic organ metastasis exists, and (3) that pulmonary disease has been completely removed without compromising pulmonary function.
In their literature survey, Drs. Chao and Goldberg reach the conclusion that surgical metastasectomy is the clear treatment of choice and should be the standard of care for patients with pulmonary recurrences of soft-tissue sarcoma. It is assumed that survival without this operation is negligible, even while there are no survival statistics for sarcoma patients who are eligible for metastasectomy and who choose to forgo this option.
The lung is the most frequent site of metastasis from soft-tissue sarcomas. Due to the relative resistance of sarcoma to either chemotherapy or radiotherapy, compared to other solid tumors, surgical management of
In their article, Chao and Goldberg provide a concise overview of the literature on pulmonary metastasectomy for sarcoma, including a brief history of the procedure, guidelines for preoperative evaluation, conduct of the operation, and probable outcomes achieved. Several points that they review deserve further discussion.
Kaposi’s sarcoma (KS) is the most common malignancy associated with the acquired immunodeficiency syndrome (AIDS). Recent years have witnessed a decline in the overall incidence of AIDS-related KS, as well as a greater
SAN FRANCISCO-Because Kaposi’s sarcoma is a highly vascular tumor, vascular endothelial growth factor (VEGF) may be a possible regulator for the edema and angiogenesis often seen in the disease, Parkash Gill, MD, of the Norris Cancer Center, University of Southern California, said at the 39th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC).
BUFFALO, NY-There are too many questions and not enough new answers about soft tissue sarcomas, Raphael E. Pollock, MD, PhD, said at the Surgical Oncology Symposium, hosted by Roswell Park Cancer Institute.
ROCKVILLE, Md-Doxil (doxorubicin HCl liposome injection, ALZA Corporation) has won accelerated FDA approval of its supplemental New Drug Application for the treatment of metastatic ovarian cancer refractory to both paclitaxel (Taxol)- and platinum-based chemotherapy regimens. Accelerated approval requires the company to conduct additional research to demonstrate that the drug is associated with clinical benefit. Doxil, a liposomal formulation of doxorubicin, is currently approved for use in AIDS-related Kaposi’s sarcoma.
ASCO-In a phase II trial, more than one-third of patients with AIDS-related Kaposi’s sarcoma responded to self-administration of a nasal solution containing the small antiangiogenic peptide IM862, Parkash Gill, MD, of the University of Southern California, reported at the ASCO annual meeting.
SAN FRANCISCO-“Kaposi’s sarcoma (KS) conforms very poorly to conventional notions about cancer,” Donald Ganem, MD, of the University of California, San Francisco, said at a conference on globally emerging viral infections. “It’s properly classified as in the gray zone between proliferative hyperplasia and frank neoplasm.”
Dr. Nag and colleagues provide an overview of brachytherapy, describe its application in pediatric oncology, and review the clinical experience in childhood solid tumors. The limited number of publications includes Dr. Nag’s own important, innovative clinical research using remote afterloading high-dose-rate (HDR) brachytherapy with twice-daily fractions in children with sarcoma.[1]
