PURPOSE: Alternatives to cytotoxic agents are desirable for patients with HIV-associated Kaposi's sarcoma (KS). Vascular endothelial growth factor-A (VEGF-A) contributes to KS pathogenesis. We evaluated the humanized anti-VEGF-A monoclonal antibody, bevacizumab, in patients with HIV-KS. PATIENTS AND METHODS: Patients with HIV-KS who either experienced progression while receiving highly active antiretroviral therapy (HAART) for at least 1 month or did not regress despite HAART for at least 4 months were administered bevacizumab 15 mg/kg intravenously on days 1 and 8 and then every 3 weeks. The primary objective was assessment of antitumor activity using modified AIDS Clinical Trial Group (ACTG) criteria for HIV-KS. HIV-uninfected patients were also eligible and observed separately. RESULTS: Seventeen HIV-infected patients were enrolled. Fourteen patients had been receiving effective HAART for at least 6 months (median, 1 year). Thirteen patients had advanced disease (ACTG T(1)), 13 patients had received prior chemotherapy for KS, and seven patients had CD4 count less than 200 cells/μL. Median number of cycles was 10 (range, 1 to 37 cycles); median follow-up was 8.3 months (range, 3 to 36 months). Of 16 assessable patients, best tumor responses observed were complete response (CR) in three patients (19%), partial response (PR) in two patients (12%), stable disease in nine patients (56%), and progressive disease in two patients (12%). Overall response rate (CR + PR) was 31% (95% CI, 11% to 58.7%). Four of five responders had received prior chemotherapy for KS. Over 202 cycles, grade 3 to 4 adverse events at least possibly attributed to therapy included hypertension (n = 7), neutropenia (n = 5), cellulitis (n = 3), and headache (n = 2). CONCLUSION: Bevacizumab is tolerated in patients with HIV-KS and has activity in a subset of patients.
PURPOSE: Alternatives to cytotoxic agents are desirable for patients with HIV-associated Kaposi's sarcoma (KS). Vascular endothelial growth factor-A (VEGF-A) contributes to KS pathogenesis. We evaluated the humanized anti-VEGF-A monoclonal antibody, bevacizumab, in patients with HIV-KS. PATIENTS AND METHODS: Patients with HIV-KS who either experienced progression while receiving highly active antiretroviral therapy (HAART) for at least 1 month or did not regress despite HAART for at least 4 months were administered bevacizumab 15 mg/kg intravenously on days 1 and 8 and then every 3 weeks. The primary objective was assessment of antitumor activity using modified AIDS Clinical Trial Group (ACTG) criteria for HIV-KS. HIV-uninfectedpatients were also eligible and observed separately. RESULTS: Seventeen HIV-infectedpatients were enrolled. Fourteen patients had been receiving effective HAART for at least 6 months (median, 1 year). Thirteen patients had advanced disease (ACTG T(1)), 13 patients had received prior chemotherapy for KS, and seven patients had CD4 count less than 200 cells/μL. Median number of cycles was 10 (range, 1 to 37 cycles); median follow-up was 8.3 months (range, 3 to 36 months). Of 16 assessable patients, best tumor responses observed were complete response (CR) in three patients (19%), partial response (PR) in two patients (12%), stable disease in nine patients (56%), and progressive disease in two patients (12%). Overall response rate (CR + PR) was 31% (95% CI, 11% to 58.7%). Four of five responders had received prior chemotherapy for KS. Over 202 cycles, grade 3 to 4 adverse events at least possibly attributed to therapy included hypertension (n = 7), neutropenia (n = 5), cellulitis (n = 3), and headache (n = 2). CONCLUSION:Bevacizumab is tolerated in patients with HIV-KS and has activity in a subset of patients.
Authors: B J Dezube; J H Von Roenn; J Holden-Wiltse; T W Cheung; S C Remick; T P Cooley; J Moore; J P Sommadossi; S L Shriver; C W Suckow; P S Gill Journal: J Clin Oncol Date: 1998-04 Impact factor: 44.544
Authors: S Stewart; H Jablonowski; F D Goebel; K Arasteh; M Spittle; A Rios; D Aboulafia; J Galleshaw; B J Dezube Journal: J Clin Oncol Date: 1998-02 Impact factor: 44.544
Authors: L Welles; M W Saville; J Lietzau; J M Pluda; K M Wyvill; I Feuerstein; W D Figg; R Lush; J Odom; W H Wilson; M T Fajardo; R W Humphrey; E Feigal; D Tuck; S M Steinberg; S Broder; R Yarchoan Journal: J Clin Oncol Date: 1998-03 Impact factor: 44.544
Authors: S Marchiò; L Primo; M Pagano; G Palestro; A Albini; T Veikkola; I Cascone; K Alitalo; F Bussolino Journal: J Biol Chem Date: 1999-09-24 Impact factor: 5.157
Authors: C Bais; B Santomasso; O Coso; L Arvanitakis; E G Raaka; J S Gutkind; A S Asch; E Cesarman; M C Gershengorn; E A Mesri; M C Gerhengorn Journal: Nature Date: 1998-01-01 Impact factor: 49.962
Authors: D W Northfelt; B J Dezube; J A Thommes; B J Miller; M A Fischl; A Friedman-Kien; L D Kaplan; C Du Mond; R D Mamelok; D H Henry Journal: J Clin Oncol Date: 1998-07 Impact factor: 44.544
Authors: Konstantinos Liapis; Andrew Clear; Andrew Owen; Rita Coutinho; Paul Greaves; Abigail M Lee; Silvia Montoto; Maria Calaminici; John G Gribben Journal: Blood Date: 2013-05-07 Impact factor: 22.113
Authors: Ramya Ramaswami; Thomas S Uldrick; Mark N Polizzotto; Kathleen M Wyvill; Priscila Goncalves; Anaida Widell; Kathryn Lurain; Seth M Steinberg; William Douglas Figg; Giovanna Tosato; Denise Whitby; Robert Yarchoan Journal: Clin Cancer Res Date: 2019-04-12 Impact factor: 12.531
Authors: Rachel A Bender Ignacio; Jeannette Y Lee; Michelle A Rudek; Dirk P Dittmer; Richard F Ambinder; Susan E Krown Journal: J Acquir Immune Defic Syndr Date: 2016-05-01 Impact factor: 3.731
Authors: Meilan He; Fan Cheng; Suzane Ramos da Silva; Brandon Tan; Océane Sorel; Marion Gruffaz; Tingting Li; Shou-Jiang Gao Journal: Cancer Treat Res Date: 2019