Classic Kaposi Sarcoma Progressive on Anthracycline Therapy: Next-Line Management

This protocol applies when Classic Kaposi sarcoma (KS) continues to progress despite first-line anthracycline-based systemic treatment, and escalation to a second-line regimen is required.

Previous line — failure condition

First-line systemic therapy — pegylated liposomal doxorubicin or liposomal daunorubicin — did not achieve partial remission of KS lesions. Progression on anthracycline therapy is the criterion that triggers escalation to this protocol.

Second-line approach (partial overview)

A taxane-class chemotherapy agent is indicated as the second-line intervention in this setting. The clinical objective is remission of KS lesions. Dosing, scheduling, and the complete clinical algorithm are available in the full protocol.

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References

DOI: 10.1111/ddg.14788

Paclitaxel should therefore be used as second-line therapy when KS is progressive on anthracycline therapy.

The recommended dose is 100 mg/m² i.v. over 3–4 hours every two weeks.

Paclitaxel is effective in KS and achieves remission in approximately 60 %.

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