Chemioterapia nel sarcoma di Kaposi mediterraneo: 20 anni di esperienza

Background. When classical Kaposi's sarcoma (CKS) shows an aggressive behaviour, the use of systemic chemotherapy is indicated. Several drugs are active in this disease, but the role of single agents, both in the first and second line, is not yet clear. The 20 years experience of a referral group in Italy is reported here. Methods. One hundred and twenty patients were treated with seven drugs in monochemotherapy: vinblastine, vinorelbine and oral etoposide in the first line and vinblastine, i.v. etoposide, gemcitabine and i.m. bleomycin in the second line. Objective responses and toxicity were evaluated according to WHO criteria. Results. In the first line, the activity of therapy was similar (CR+ PR: 60-80%), whereas in the second line it was 50% for drugs used in the second line apart from gemcitabine which has given 100% response. Toxicity was limited and acceptable for each treatment. Personal experience confirms the usefulness of treating patients affected by aggressive CKS with systemic chemotherapy, in order to obtain control of the disease and to reduce the related symptoms. Conclusions. The evaluation of the role of a drug in comparison to another one requires the implementation of a large comparative trials, in order to establish a 'standard' systemic treatment for this disease.