Randomized Phase IIA Trial of Gemcitabine Compared With Bleomycin Plus Vincristine for Treatment of Kaposi's Sarcoma in Patients on Combination Antiretroviral Therapy in Western Kenya.

Autor:	Busakhala NW; Naftali W. Busakhala, Gabriel Kimutai Kigen, Moi University School of Medicine; Alfred Kipyegon Keter, and Patrick J. Loehrer Sr, AMPATH Statistics, Eldoret, Kenya; Paul J. Waako, Makerere College of Health Sciences, Kampala, Uganda; Matthew Robert Strother, Canterbury District Health Board, and University of Otago, Christchurch, New Zealand; Fredrick Chite Asirwa, Indiana University Simon Cancer Center, Indianapolis, IN., Waako PJ; Naftali W. Busakhala, Gabriel Kimutai Kigen, Moi University School of Medicine; Alfred Kipyegon Keter, and Patrick J. Loehrer Sr, AMPATH Statistics, Eldoret, Kenya; Paul J. Waako, Makerere College of Health Sciences, Kampala, Uganda; Matthew Robert Strother, Canterbury District Health Board, and University of Otago, Christchurch, New Zealand; Fredrick Chite Asirwa, Indiana University Simon Cancer Center, Indianapolis, IN., Strother MR; Naftali W. Busakhala, Gabriel Kimutai Kigen, Moi University School of Medicine; Alfred Kipyegon Keter, and Patrick J. Loehrer Sr, AMPATH Statistics, Eldoret, Kenya; Paul J. Waako, Makerere College of Health Sciences, Kampala, Uganda; Matthew Robert Strother, Canterbury District Health Board, and University of Otago, Christchurch, New Zealand; Fredrick Chite Asirwa, Indiana University Simon Cancer Center, Indianapolis, IN., Keter AK; Naftali W. Busakhala, Gabriel Kimutai Kigen, Moi University School of Medicine; Alfred Kipyegon Keter, and Patrick J. Loehrer Sr, AMPATH Statistics, Eldoret, Kenya; Paul J. Waako, Makerere College of Health Sciences, Kampala, Uganda; Matthew Robert Strother, Canterbury District Health Board, and University of Otago, Christchurch, New Zealand; Fredrick Chite Asirwa, Indiana University Simon Cancer Center, Indianapolis, IN., Kigen GK; Naftali W. Busakhala, Gabriel Kimutai Kigen, Moi University School of Medicine; Alfred Kipyegon Keter, and Patrick J. Loehrer Sr, AMPATH Statistics, Eldoret, Kenya; Paul J. Waako, Makerere College of Health Sciences, Kampala, Uganda; Matthew Robert Strother, Canterbury District Health Board, and University of Otago, Christchurch, New Zealand; Fredrick Chite Asirwa, Indiana University Simon Cancer Center, Indianapolis, IN., Asirwa FC; Naftali W. Busakhala, Gabriel Kimutai Kigen, Moi University School of Medicine; Alfred Kipyegon Keter, and Patrick J. Loehrer Sr, AMPATH Statistics, Eldoret, Kenya; Paul J. Waako, Makerere College of Health Sciences, Kampala, Uganda; Matthew Robert Strother, Canterbury District Health Board, and University of Otago, Christchurch, New Zealand; Fredrick Chite Asirwa, Indiana University Simon Cancer Center, Indianapolis, IN., Loehrer PJ; Naftali W. Busakhala, Gabriel Kimutai Kigen, Moi University School of Medicine; Alfred Kipyegon Keter, and Patrick J. Loehrer Sr, AMPATH Statistics, Eldoret, Kenya; Paul J. Waako, Makerere College of Health Sciences, Kampala, Uganda; Matthew Robert Strother, Canterbury District Health Board, and University of Otago, Christchurch, New Zealand; Fredrick Chite Asirwa, Indiana University Simon Cancer Center, Indianapolis, IN.
Jazyk:	angličtina
Zdroj:	Journal of global oncology [J Glob Oncol] 2018 Sep; Vol. 4, pp. 1-9.
DOI:	10.1200/JGO.17.00077
Abstrakt:	Purpose: Kaposi's sarcoma (KS) is a spindle cell tumor resulting from growth dysregulation in the setting of infection with human herpes virus-8 (also called KS herpes virus). Advanced KS is characterized by poor responses to antiretroviral therapy and some of the chemotherapy readily accessible to patients in low-resource areas. Gemcitabine induced partial and complete regression of AIDS-associated KS (AIDS-KS) in 11 of 24 patients in a pilot study. The current study compares the antimetabolite gemcitabine with the standard care bleomycin and vincristine (BV) in the treatment of chemotherapy-naïve patients with AIDS-KS in a resource-limited setting. Patients and Methods: Patients with persistent or progressive KS despite treatment with combined antiretroviral therapy were randomly assigned to receive gemcitabine 1,000 mg/m 2 or bleomycin 15 IU/ m 2 and vincristine 1.4 mg/m 2 given twice weekly. The main end point was objective response by bidirectional measurement, adverse events, and quality of life after three cycles of chemotherapy. Results: Of 70 participants enrolled, 36 received gemcitabine and 34 received BV. Complete response was achieved in 12 patients (33.3%) in the gemcitabine arm and six (17.6%) in the BV arm ( P = .175). The partial response rate was 52.8% (n = 19) in the gemcitabine arm and 58.8% (n = 20) in the BV arm. Both study arms reported similar neurologic and hematologic adverse events; there was statistically significant baseline to post-treatment improvement in health-related quality-of-life scores. Conclusion: The results of this randomized, phase IIA trial demonstrate gemcitabine activity in chemotherapy-naïve patients with AIDS-KS, on the basis of response rates, adverse events, and health-related quality-of-life scores.
Databáze:	MEDLINE
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