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Clinical Activity of Lenalidomide in Visceral Human Immunodeficiency Virus-Related Kaposi Sarcoma.
MedLine Citation:
PMID:  24080749     Owner:  NLM     Status:  Publisher    
IMPORTANCE Curative treatment of aggressive Kaposi sarcoma (KS) with conventional chemotherapy in human immunodeficiency virus (HIV)-infected patients remains difficult. The administration of thalidomide, an immunomodulatory drug with antiangiogenic effects, is limited by its toxicity. This engenders interest in evaluating thalidomide analogues such as lenalidomide with better toxicity profiles. To our knowledge, we describe for the first time a patient with visceral KS successfully treated with lenalidomide. OBSERVATIONS A man with advanced visceral HIV-related KS progressing after 11 months of highly active antiretroviral therapy (HAART) and 2 lines of conventional chemotherapy (pegylated liposomal doxorubicin and docetaxel) was treated with lenalidomide on a compassionate use basis. He showed a rapid partial response without any substantial adverse effect but experienced relapse after 5 months of treatment, in a context of virologic failure. CONCLUSIONS AND RELEVANCE Similar to our observation, good partial response without toxic effects has been reported in 3 patients with only skin involvement. Because immune reconstitution syndrome may occur in HIV-infected patients with KS undergoing HAART, KS improvement may be partly explained by immune recovery. An ongoing US phase 1/2 trial will better evaluate the efficacy and tolerance of lenalidomide in patients with HIV-related KS with and without visceral involvement.
Maud Steff; Véronique Joly; Julie Di Lucca; Judith Feldman; Samuel Burg; Laure Sarda-Mantel; Gilles Peytavin; Eduardo Marinho; Béatrice Crickx; Eric Raymond; Sylvie Lariven; Eve Maubec
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-10-2
Journal Detail:
Title:  JAMA dermatology (Chicago, Ill.)     Volume:  -     ISSN:  2168-6084     ISO Abbreviation:  JAMA Dermatol     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-10-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101589530     Medline TA:  JAMA Dermatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Service de Dermatologie, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France2Université Paris Diderot Sorbonne Paris Cité, Paris, France.
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