In endemic Kaposi sarcoma, first-line systemic treatment targets measurable tumour response. When that response is not achieved, a defined second-line protocol is applied. This page describes the failure condition that triggers escalation and the direction of the next step.
First-line systemic therapy — which may include pegylated liposomal doxorubicin, liposomal daunorubicin, or Interferon-α — aims for partial remission of Kaposi sarcoma after a course of infusions. The treatment goals are reduction in size, thickness, and coloration of the tumours, and reduction of oedema.
When these targets are not achieved, escalation to second-line therapy is indicated.
Second-line management incorporates paclitaxel, targeting remission of Kaposi sarcoma with reduction in tumour size, thickness, coloration, and oedema.