Intralesional vincristine as first-line therapy for nodular lesions in classic Kaposi sarcoma: A prospective study in 151 patients

L. Brambilla, M. Bellinvia, A. Tourlaki, B. Scoppio, F. Gaiani, V. Boneschi

Research output: Contribution to journalArticle

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Abstract

Background Classic Kaposi sarcoma is a rare angioproliferative neoplasm with varying biological behaviour. Depending on the clinical stage, local or systemic therapy can be used. Vincristine has proven to be effective as systemic chemotherapy and in very few reports as intralesional treatment. Objectives Our aim was to determine the efficacy and safety of intralesional vincristine in the treatment of classic Kaposi sarcoma nodular lesions. Methods We conducted a prospective, open-label, single-centre clinical trial in 151 patients with stage IB classic Kaposi sarcoma. Vincristine was injected in a single nodule (0·3-0·8 mm) on the lower limb. Another similar lesion on the same limb, at a distance of ≥ 10 cm, or on the contralateral limb, was kept under clinical observation as control. Adverse effects were evaluated after 1 week, and efficacy after 4 and 12 weeks. Results One hundred and fifty-one patients were enrolled. At final evaluation, 115 patients presented complete response (76·1%), 28 had partial response (18·5%), six had improvement (4%), one had stable disease (0·7%) and only one patient had tumour progression (0·7%). Therefore the total response rate was 98·7% (149 patients). Therapy was generally well tolerated. The most frequently registered adverse events, observed in 21 patients (13·9%), were erythema and itching. Conclusions Intralesional vincristine is an effective and safe treatment for nodular lesions in classic Kaposi sarcoma and can be recommended as first-line therapy in initial stages and as support therapy in advanced stages.

Original languageEnglish
Pages (from-to)854-859
Number of pages6
JournalBritish Journal of Dermatology
Volume162
Issue number4
DOIs
Publication statusPublished - 2010

Fingerprint

Kaposi's Sarcoma
Vincristine
Prospective Studies
Therapeutics
Extremities
Erythema
Pruritus
Lower Extremity
Neoplasms
Observation
Clinical Trials
Safety
Drug Therapy

Keywords

  • Classic Kaposi sarcoma
  • Intralesional chemotherapy
  • Therapy
  • Vincristine

ASJC Scopus subject areas

  • Dermatology
  • Medicine(all)

Cite this

Intralesional vincristine as first-line therapy for nodular lesions in classic Kaposi sarcoma : A prospective study in 151 patients. / Brambilla, L.; Bellinvia, M.; Tourlaki, A.; Scoppio, B.; Gaiani, F.; Boneschi, V.

In: British Journal of Dermatology, Vol. 162, No. 4, 2010, p. 854-859.

Research output: Contribution to journalArticle

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abstract = "Background Classic Kaposi sarcoma is a rare angioproliferative neoplasm with varying biological behaviour. Depending on the clinical stage, local or systemic therapy can be used. Vincristine has proven to be effective as systemic chemotherapy and in very few reports as intralesional treatment. Objectives Our aim was to determine the efficacy and safety of intralesional vincristine in the treatment of classic Kaposi sarcoma nodular lesions. Methods We conducted a prospective, open-label, single-centre clinical trial in 151 patients with stage IB classic Kaposi sarcoma. Vincristine was injected in a single nodule (0·3-0·8 mm) on the lower limb. Another similar lesion on the same limb, at a distance of ≥ 10 cm, or on the contralateral limb, was kept under clinical observation as control. Adverse effects were evaluated after 1 week, and efficacy after 4 and 12 weeks. Results One hundred and fifty-one patients were enrolled. At final evaluation, 115 patients presented complete response (76·1{\%}), 28 had partial response (18·5{\%}), six had improvement (4{\%}), one had stable disease (0·7{\%}) and only one patient had tumour progression (0·7{\%}). Therefore the total response rate was 98·7{\%} (149 patients). Therapy was generally well tolerated. The most frequently registered adverse events, observed in 21 patients (13·9{\%}), were erythema and itching. Conclusions Intralesional vincristine is an effective and safe treatment for nodular lesions in classic Kaposi sarcoma and can be recommended as first-line therapy in initial stages and as support therapy in advanced stages.",
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AU - Scoppio, B.

AU - Gaiani, F.

AU - Boneschi, V.

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N2 - Background Classic Kaposi sarcoma is a rare angioproliferative neoplasm with varying biological behaviour. Depending on the clinical stage, local or systemic therapy can be used. Vincristine has proven to be effective as systemic chemotherapy and in very few reports as intralesional treatment. Objectives Our aim was to determine the efficacy and safety of intralesional vincristine in the treatment of classic Kaposi sarcoma nodular lesions. Methods We conducted a prospective, open-label, single-centre clinical trial in 151 patients with stage IB classic Kaposi sarcoma. Vincristine was injected in a single nodule (0·3-0·8 mm) on the lower limb. Another similar lesion on the same limb, at a distance of ≥ 10 cm, or on the contralateral limb, was kept under clinical observation as control. Adverse effects were evaluated after 1 week, and efficacy after 4 and 12 weeks. Results One hundred and fifty-one patients were enrolled. At final evaluation, 115 patients presented complete response (76·1%), 28 had partial response (18·5%), six had improvement (4%), one had stable disease (0·7%) and only one patient had tumour progression (0·7%). Therefore the total response rate was 98·7% (149 patients). Therapy was generally well tolerated. The most frequently registered adverse events, observed in 21 patients (13·9%), were erythema and itching. Conclusions Intralesional vincristine is an effective and safe treatment for nodular lesions in classic Kaposi sarcoma and can be recommended as first-line therapy in initial stages and as support therapy in advanced stages.

AB - Background Classic Kaposi sarcoma is a rare angioproliferative neoplasm with varying biological behaviour. Depending on the clinical stage, local or systemic therapy can be used. Vincristine has proven to be effective as systemic chemotherapy and in very few reports as intralesional treatment. Objectives Our aim was to determine the efficacy and safety of intralesional vincristine in the treatment of classic Kaposi sarcoma nodular lesions. Methods We conducted a prospective, open-label, single-centre clinical trial in 151 patients with stage IB classic Kaposi sarcoma. Vincristine was injected in a single nodule (0·3-0·8 mm) on the lower limb. Another similar lesion on the same limb, at a distance of ≥ 10 cm, or on the contralateral limb, was kept under clinical observation as control. Adverse effects were evaluated after 1 week, and efficacy after 4 and 12 weeks. Results One hundred and fifty-one patients were enrolled. At final evaluation, 115 patients presented complete response (76·1%), 28 had partial response (18·5%), six had improvement (4%), one had stable disease (0·7%) and only one patient had tumour progression (0·7%). Therefore the total response rate was 98·7% (149 patients). Therapy was generally well tolerated. The most frequently registered adverse events, observed in 21 patients (13·9%), were erythema and itching. Conclusions Intralesional vincristine is an effective and safe treatment for nodular lesions in classic Kaposi sarcoma and can be recommended as first-line therapy in initial stages and as support therapy in advanced stages.

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