Iatrogenic Kaposi Sarcoma: Next-Line Treatment When Local Therapy Has Not Controlled the Lesions
Iatrogenic Kaposi sarcoma can be managed initially with local approaches targeting individual cutaneous lesions. When these measures fail to achieve the required degree of lesion control, the clinical pathway moves to a systemic treatment line.
Previous line — failure condition
Local therapy of individual cutaneous lesions — which may include radiotherapy, cryotherapy, surgical excision, intralesional vincristine or vinblastine, topical alitretinoin gel, or topical imiquimod cream — did not achieve sufficient reduction in tumor size, thickness, coloration, or edema of the cutaneous lesions.
Next-line approach
When local control is inadequate, the next step is a systemic chemotherapy regimen. The complete protocol — including the specific agent, administration schedule, and monitoring approach — is structured around achieving partial remission of Kaposi sarcoma lesions, a goal that is typically assessable after a defined course of infusions.
References
DOI: 10.1111/ddg.14788
- Systemic chemotherapy should be considered in patients with visceral involvement, extensive lymph node involvement, or progressive mucocutaneous involvement.
- Doxorubicine (pegylated, liposomal) is most commonly used.
- Pegylated liposomal doxorubicine at a dose of 20 mg/m² body surface area i.v. every 2–3 weeks can achieve partial remissions in up to 60–80 % of treated patients.
- In most cases, a profound partial remission is achieved after about 3–6 infusions, whereas some patients require more infusions to achieve a response.
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