Randomized Trial of Paclitaxel versus Pegylated Liposomal Doxorubicin for Advanced Human Immunodeficiency Virus-associated Kaposi’s Sarcoma: Evidence for Symptom Palliation from Chemotherapy
Identifieur interne : 005663 ( Main/Exploration ); précédent : 005662; suivant : 005664Randomized Trial of Paclitaxel versus Pegylated Liposomal Doxorubicin for Advanced Human Immunodeficiency Virus-associated Kaposi’s Sarcoma: Evidence for Symptom Palliation from Chemotherapy
Auteurs : Mary Cianfrocca ; Sandra Lee [États-Unis] ; Jamie Von Roenn ; Anile Tulpule [États-Unis] ; Bruce J. Dezube ; David M. Aboulafia [États-Unis] ; Richard F. Ambinder [États-Unis] ; Jeannette Y. Lee [États-Unis] ; Susan E. Krown [États-Unis] ; Joseph A. Sparano [États-Unis]Source :
- Cancer [ 0008-543X ] ; 2010.
Abstract
Paclitaxel (PTX) and pegylated liposomal doxorubicin (PLD) are active cytotoxic agents for the treatment of human immunodeficiency (HIV) associated Kaposi’s sarcoma (KS). We performed a randomized trial comparing the efficacy and toxicity of PTX and PLD, and determine the effects of therapy on symptom palliation and quality of life.
Patients with advanced HIV-associated KS were randomly assigned to receive PTX (100 mg/m2) IV every 2 weeks, or PLD 20 mg/m2 IV every 3 weeks. The KS Functional Assessment of HIV (FAHI) Quality of Life instrument was used before and after every other treatment cycle.
The study included 73 analyzable patients enrolled between 1998 and 2002, including 36 in the PTX arm and 37 in the PLD arm; 73% received highly active antiretroviral therapy (HAART) and 32% had undetectable viral load (<400 copies/mL). Treatment was associated with significant improvement in pain (P=0.024) and swelling (P<0.001). Of the 36 patients who reported that pain interfered with their normal work or activities at baseline, 25 (69%) improved. Of the 41 patients who reported swelling at baseline, 38 (93%) improved. Comparing the PTX and PLD arms revealed comparable response rates (56% vs. 46%; p=0.49), median progression free survival (17.5 vs. 12.2 months; p=0.66), and 2-year survival (79% vs. 78%; p=0.75), but somewhat more grade 3–5 toxicity for PTX (84% vs. 66%, p=0.077).
Treatment with either PTX or PLD produces significant improvement in pain and swelling in patients with advanced, symptomatic, HIV-associated KS treated in the early HAART era.
Url:
DOI: 10.1002/cncr.25362
PubMed: 20564162
PubMed Central: 3157242
Affiliations:
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Dezube</name><affiliation><nlm:aff id="A4">Beth Israel Deaconess Medical Center, Harvard Medical School, Boston MA</nlm:aff><wicri:noCountry code="subfield">Boston MA</wicri:noCountry></affiliation></author><author><name sortKey="Aboulafia, David M" sort="Aboulafia, David M" uniqKey="Aboulafia D" first="David M." last="Aboulafia">David M. Aboulafia</name><affiliation wicri:level="2"><nlm:aff id="A5">Virginia Mason Medical Center, Seattle, Washington</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Washington (État)</region></placeName><wicri:cityArea>Virginia Mason Medical Center, Seattle</wicri:cityArea></affiliation></author><author><name sortKey="Ambinder, Richard F" sort="Ambinder, Richard F" uniqKey="Ambinder R" first="Richard F." last="Ambinder">Richard F. Ambinder</name><affiliation wicri:level="2"><nlm:aff id="A6">Richard F. Ambinder, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Maryland</region></placeName><wicri:cityArea>Richard F. Ambinder, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore</wicri:cityArea></affiliation></author><author><name sortKey="Lee, Jeannette Y" sort="Lee, Jeannette Y" uniqKey="Lee J" first="Jeannette Y." last="Lee">Jeannette Y. Lee</name><affiliation wicri:level="2"><nlm:aff id="A7">University of Arkansas, Little Rock, AR</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Arkansas</region></placeName><wicri:cityArea>University of Arkansas, Little Rock</wicri:cityArea></affiliation></author><author><name sortKey="Krown, Susan E" sort="Krown, Susan E" uniqKey="Krown S" first="Susan E." last="Krown">Susan E. Krown</name><affiliation wicri:level="2"><nlm:aff id="A8">Memorial Sloan Kettering Cancer Center, New York, NY</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Memorial Sloan Kettering Cancer Center, New York</wicri:cityArea></affiliation></author><author><name sortKey="Sparano, Joseph A" sort="Sparano, Joseph A" uniqKey="Sparano J" first="Joseph A." last="Sparano">Joseph A. Sparano</name><affiliation wicri:level="2"><nlm:aff id="A9">Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Albert Einstein College of Medicine, Montefiore Medical Center, Bronx</wicri:cityArea></affiliation></author></analytic><series><title level="j">Cancer</title><idno type="ISSN">0008-543X</idno><idno type="eISSN">1097-0142</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title><p id="P1">Paclitaxel (PTX) and pegylated liposomal doxorubicin (PLD) are active cytotoxic agents for the treatment of human immunodeficiency (HIV) associated Kaposi’s sarcoma (KS). We performed a randomized trial comparing the efficacy and toxicity of PTX and PLD, and determine the effects of therapy on symptom palliation and quality of life.</p></sec><sec sec-type="methods" id="S2"><title>Methods</title><p id="P2">Patients with advanced HIV-associated KS were randomly assigned to receive PTX (100 mg/m<sup>2</sup>) IV every 2 weeks, or PLD 20 mg/m2 IV every 3 weeks. The KS Functional Assessment of HIV (FAHI) Quality of Life instrument was used before and after every other treatment cycle.</p></sec><sec id="S3"><title>Results</title><p id="P3">The study included 73 analyzable patients enrolled between 1998 and 2002, including 36 in the PTX arm and 37 in the PLD arm; 73% received highly active antiretroviral therapy (HAART) and 32% had undetectable viral load (<400 copies/mL). Treatment was associated with significant improvement in pain (P=0.024) and swelling (P<0.001). Of the 36 patients who reported that pain interfered with their normal work or activities at baseline, 25 (69%) improved. Of the 41 patients who reported swelling at baseline, 38 (93%) improved. Comparing the PTX and PLD arms revealed comparable response rates (56% vs. 46%; p=0.49), median progression free survival (17.5 vs. 12.2 months; p=0.66), and 2-year survival (79% vs. 78%; p=0.75), but somewhat more grade 3–5 toxicity for PTX (84% vs. 66%, p=0.077).</p></sec><sec id="S4"><title>Conclusion</title><p id="P4">Treatment with either PTX or PLD produces significant improvement in pain and swelling in patients with advanced, symptomatic, HIV-associated KS treated in the early HAART era.</p></sec></div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Arkansas</li><li>Californie</li><li>Maryland</li><li>Massachusetts</li><li>Washington (État)</li><li>État de New York</li></region></list><tree><noCountry><name sortKey="Cianfrocca, Mary" sort="Cianfrocca, Mary" uniqKey="Cianfrocca M" first="Mary" last="Cianfrocca">Mary Cianfrocca</name><name sortKey="Dezube, Bruce J" sort="Dezube, Bruce J" uniqKey="Dezube B" first="Bruce J." last="Dezube">Bruce J. Dezube</name><name sortKey="Von Roenn, Jamie" sort="Von Roenn, Jamie" uniqKey="Von Roenn J" first="Jamie" last="Von Roenn">Jamie Von Roenn</name></noCountry><country name="États-Unis"><region name="Massachusetts"><name sortKey="Lee, Sandra" sort="Lee, Sandra" uniqKey="Lee S" first="Sandra" last="Lee">Sandra Lee</name></region><name sortKey="Aboulafia, David M" sort="Aboulafia, David M" uniqKey="Aboulafia D" first="David M." last="Aboulafia">David M. Aboulafia</name><name sortKey="Ambinder, Richard F" sort="Ambinder, Richard F" uniqKey="Ambinder R" first="Richard F." last="Ambinder">Richard F. Ambinder</name><name sortKey="Krown, Susan E" sort="Krown, Susan E" uniqKey="Krown S" first="Susan E." last="Krown">Susan E. Krown</name><name sortKey="Lee, Jeannette Y" sort="Lee, Jeannette Y" uniqKey="Lee J" first="Jeannette Y." last="Lee">Jeannette Y. Lee</name><name sortKey="Sparano, Joseph A" sort="Sparano, Joseph A" uniqKey="Sparano J" first="Joseph A." last="Sparano">Joseph A. Sparano</name><name sortKey="Tulpule, Anile" sort="Tulpule, Anile" uniqKey="Tulpule A" first="Anile" last="Tulpule">Anile Tulpule</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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