Treatment outcomes of patients with classic and AIDS-related Kaposi Sarcoma: a single-center real-world experience

• Published in: Clinical and experimental medicine 2023-12, Vol.23 (8), p.5463-5471
• Main Authors: Valcarcel-Valdivia, Bryan, Enriquez-Vera, Daniel, Piedra, Luis Enrique, Holguín, Alexis, De la Cruz Ku, Gabriel
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Acquired Immunodeficiency Syndrome - complications; Acquired Immunodeficiency Syndrome - drug therapy; Adult; AIDS; Chemotherapy; Clinical Practice; Clinical trials; Developing countries; Hematology; Humans; Immunodeficiency; Internal Medicine; Kaposis sarcoma; LDCs; Medical records; Medicine; Medicine & Public Health; Middle Aged; Oncology; Paclitaxel; Patients; Retrospective Studies; Sarcoma; Sarcoma, Kaposi - drug therapy; Treatment Outcome; Young Adult
• ISSN: 1591-9528; 1591-8890; 1591-9528
• DOI: 10.1007/s10238-023-01246-3

The recommended first-line chemotherapy agents for managing Kaposi sarcoma (KS) in high-income countries are expensive and often unavailable in developing nations such as Peru. Limited data exist on whether management practices in these countries affect patient outcomes. We assessed the real-world treatment approaches and outcomes of patients with KS in Peru. We retrospectively reviewed the medical records of patients with acquired immunodeficiency syndrome-related KS (AIDS-related KS; n  = 95) and classic KS (CKS; n  = 81) diagnosed at a tertiary center between 2000 and 2014 in Lima, Peru. We used the Kaplan–Meier method to estimate overall survival (OS) rates. The median follow-up was 64 months for AIDS-related KS and 88 months for CKS. The median age of patients with AIDS-related KS was 35 years (range 20–63 years) and 70 years (range 33–91 years) for those with CKS. Most individuals had an Eastern Cooperative Oncology Group performance status of ≥ 2 (AIDS-related KS 75%; CKS 85%). Seventy-six percent and 40% of individuals with AIDS-related KS and CKS, respectively, received systemic chemotherapy. The most common first-line drug was paclitaxel, with relatively optimal overall response rates (ORRs) for AIDS-related KS ( n  = 64/72, 89%; ORR 61%) and CKS ( n  = 24/32, 75%; ORR 50%). The 5-year OS rates were 71% in the AIDS-related KS cohort and 81% in the CKS cohort. The findings from this real-world study may inform clinical practices and highlight the need for increased access to effective treatments and clinical trials for patients with KS in Peru and other developing countries.