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Safety and effectiveness of gemcitabine for the treatment of classic Kaposi’s sarcoma without visceral involvement

BACKGROUND: Classic Kaposi’s sarcoma (CKS) is a rare, multifocal, endothelial cell neoplasm that typically occurs in elderly people with previous infection by human herpes virus-8. Prospective trials are rare, and the choice of drugs relies on prospective trials performed on HIV-associated Kaposi’s...

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Autores principales: Badalamenti, Giuseppe, Incorvaia, Lorena, Algeri, Laura, Bonasera, Annalisa, Dimino, Alessandra, Scalia, Raimondo, Cucinella, Alessandra, Madonia, Giorgio, Pomi, Federica Li, Galvano, Antonio, Gristina, Valerio, Toia, Francesca, Cordova, Adriana, Bazan, Viviana, Russo, Antonio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8958699/
https://www.ncbi.nlm.nih.gov/pubmed/35356263
http://dx.doi.org/10.1177/17588359221086829
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author Badalamenti, Giuseppe
Incorvaia, Lorena
Algeri, Laura
Bonasera, Annalisa
Dimino, Alessandra
Scalia, Raimondo
Cucinella, Alessandra
Madonia, Giorgio
Pomi, Federica Li
Galvano, Antonio
Gristina, Valerio
Toia, Francesca
Cordova, Adriana
Bazan, Viviana
Russo, Antonio
author_facet Badalamenti, Giuseppe
Incorvaia, Lorena
Algeri, Laura
Bonasera, Annalisa
Dimino, Alessandra
Scalia, Raimondo
Cucinella, Alessandra
Madonia, Giorgio
Pomi, Federica Li
Galvano, Antonio
Gristina, Valerio
Toia, Francesca
Cordova, Adriana
Bazan, Viviana
Russo, Antonio
author_sort Badalamenti, Giuseppe
collection PubMed
description BACKGROUND: Classic Kaposi’s sarcoma (CKS) is a rare, multifocal, endothelial cell neoplasm that typically occurs in elderly people with previous infection by human herpes virus-8. Prospective trials are rare, and the choice of drugs relies on prospective trials performed on HIV-associated Kaposi’s sarcoma (KS). Pegylated liposomal anthracyclines and taxanes are considered the standard first- and second-line chemotherapy, respectively. Despite the indolent biologic behavior, the natural history is characterized by recurrent disease. This condition of chronic administration of cytotoxic drugs is often associated with immediate/long-term adverse events. METHODS: This was an observational, retrospective study to evaluate the effectiveness and safety of gemcitabine in patients with CKS. From January 2016 to September 2021, the patients were treated with gemcitabine 1000 mg/m(2) on days 1 and 8, with cycles repeated every 21 days. The treatment was administered as first or second line. RESULTS: Twenty-seven (27) patients were included in the study. Twenty-one (21) out 27 patients (77.8%) achieved a partial response (PR), including 8 patients with major response (MR) (29.6%) and 13 patients with minor response (mR) (48.2%); 2 (7.4%) showed a complete response (CR), 3 (11.1%) a stable disease (SD), and 1 (3.7%) a progressive disease (PD). Tumor responses were generally rapid, with a median time to first response of 4 weeks (range, 3–12 weeks). Patients who responded had disease improvement with flattening of the skin lesions, decrease in the number of lesions, and substantial reduction in tumor-associated complications. Median duration of response was 19.2 months. Common adverse events were grades 1/2 thrombocytopenia, and grade 1 noninfectious fever. No patient discontinued treatment as a result of adverse events. CONCLUSION: Our study showed that gemcitabine is effective and well tolerated, acts rapidly on cutaneous lesions, and allows substantial symptom palliation, without dose-limiting toxicity. Gemcitabine represents a safe and effective option for the treatment of CKS.
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spelling pubmed-89586992022-03-29 Safety and effectiveness of gemcitabine for the treatment of classic Kaposi’s sarcoma without visceral involvement Badalamenti, Giuseppe Incorvaia, Lorena Algeri, Laura Bonasera, Annalisa Dimino, Alessandra Scalia, Raimondo Cucinella, Alessandra Madonia, Giorgio Pomi, Federica Li Galvano, Antonio Gristina, Valerio Toia, Francesca Cordova, Adriana Bazan, Viviana Russo, Antonio Ther Adv Med Oncol Original Research BACKGROUND: Classic Kaposi’s sarcoma (CKS) is a rare, multifocal, endothelial cell neoplasm that typically occurs in elderly people with previous infection by human herpes virus-8. Prospective trials are rare, and the choice of drugs relies on prospective trials performed on HIV-associated Kaposi’s sarcoma (KS). Pegylated liposomal anthracyclines and taxanes are considered the standard first- and second-line chemotherapy, respectively. Despite the indolent biologic behavior, the natural history is characterized by recurrent disease. This condition of chronic administration of cytotoxic drugs is often associated with immediate/long-term adverse events. METHODS: This was an observational, retrospective study to evaluate the effectiveness and safety of gemcitabine in patients with CKS. From January 2016 to September 2021, the patients were treated with gemcitabine 1000 mg/m(2) on days 1 and 8, with cycles repeated every 21 days. The treatment was administered as first or second line. RESULTS: Twenty-seven (27) patients were included in the study. Twenty-one (21) out 27 patients (77.8%) achieved a partial response (PR), including 8 patients with major response (MR) (29.6%) and 13 patients with minor response (mR) (48.2%); 2 (7.4%) showed a complete response (CR), 3 (11.1%) a stable disease (SD), and 1 (3.7%) a progressive disease (PD). Tumor responses were generally rapid, with a median time to first response of 4 weeks (range, 3–12 weeks). Patients who responded had disease improvement with flattening of the skin lesions, decrease in the number of lesions, and substantial reduction in tumor-associated complications. Median duration of response was 19.2 months. Common adverse events were grades 1/2 thrombocytopenia, and grade 1 noninfectious fever. No patient discontinued treatment as a result of adverse events. CONCLUSION: Our study showed that gemcitabine is effective and well tolerated, acts rapidly on cutaneous lesions, and allows substantial symptom palliation, without dose-limiting toxicity. Gemcitabine represents a safe and effective option for the treatment of CKS. SAGE Publications 2022-03-26 /pmc/articles/PMC8958699/ /pubmed/35356263 http://dx.doi.org/10.1177/17588359221086829 Text en © The Author(s), 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research
Badalamenti, Giuseppe
Incorvaia, Lorena
Algeri, Laura
Bonasera, Annalisa
Dimino, Alessandra
Scalia, Raimondo
Cucinella, Alessandra
Madonia, Giorgio
Pomi, Federica Li
Galvano, Antonio
Gristina, Valerio
Toia, Francesca
Cordova, Adriana
Bazan, Viviana
Russo, Antonio
Safety and effectiveness of gemcitabine for the treatment of classic Kaposi’s sarcoma without visceral involvement
title Safety and effectiveness of gemcitabine for the treatment of classic Kaposi’s sarcoma without visceral involvement
title_full Safety and effectiveness of gemcitabine for the treatment of classic Kaposi’s sarcoma without visceral involvement
title_fullStr Safety and effectiveness of gemcitabine for the treatment of classic Kaposi’s sarcoma without visceral involvement
title_full_unstemmed Safety and effectiveness of gemcitabine for the treatment of classic Kaposi’s sarcoma without visceral involvement
title_short Safety and effectiveness of gemcitabine for the treatment of classic Kaposi’s sarcoma without visceral involvement
title_sort safety and effectiveness of gemcitabine for the treatment of classic kaposi’s sarcoma without visceral involvement
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8958699/
https://www.ncbi.nlm.nih.gov/pubmed/35356263
http://dx.doi.org/10.1177/17588359221086829
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