Pegylated-liposomal doxorubicin versus doxorubicin, bleomycin, and vincristine in the treatment of AIDS-related Kaposi's sarcoma: Results of a randomized phase III clinical trial

Donald W. Northfelt, Bruce J. Dezube, James A. Thommes, Becky J. Miller, Margaret A. Fischl, Alvin Friedman-Kien, Lawrence D. Kaplan, Charles Du Mond, Richard D. Mamelok, David H. Henry

Research output: Contribution to journalArticle

490 Scopus citations

Abstract

Purpose: Kaposi's sarcoma (KS), the most common neoplasm in patients with AIDS, is a significant clinical problem for which current therapies are frequently unsatisfactory. We conducted a randomized phase III clinical trial to compare the efficacy and toxicities of a new farm of therapy, pegylated- liposomal doxorubicin, with standard combination chemotherapy in patients with advanced AIDS-related KS (AIDS-KS). Patients and Methods: Two hundred fifty-eight patients with advanced AIDS-KS were randomly assigned to receive either pegylated-liposomal doxorubicin (20 mg/m2) or the combination of doxorubicin (20 mg/m2), bleomycin (10 mg/m2) and vincristine (1 mg) (ABV) every 14 days for six cycles. Standard response criteria, toxicity criteria, and predefined indicators of clinical benefit were examined to evaluate outcomes. Results: Among 133 patients randomized to receive pegylated- liposomal doxorubicin, one achieved a complete clinical response and 60 achieved a partial response far an overall response rate of 45.9% (95% confidence interval [CI], 37% to 54%). Among 125 patients randomized to receive ABV, 31 achieved a partial response (24.8%; 95% confidence interval [CI], 17% to 32%). This difference was statistically significant (P < .001). In addition to objective responses, prospectively defined clinical benefits and toxicity outcomes also favored pegylated-liposomal doxorubicin. Conclusion: Pegylated-liposomal doxorubicin is more effective and less toxic than the standard combination chemotherapy regimen ABV far treatment of AIDS- KS.

Original languageEnglish (US)
Pages (from-to)2445-2451
Number of pages7
JournalJournal of Clinical Oncology
Volume16
Issue number7
DOIs
StatePublished - Jul 1998

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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