1. Br J Dermatol. 2010 Apr;162(4):854-9. Epub 2009 Nov 25.
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.
Department of Anesthesia, Intensive Care and Dermatologic Sciences, Università
degli Studi di Milano, Fondazione IRCCS Ospedale Maggiore Policlinico,
Mangiagalli e Regina Elena, 20122 Milan, Italy.
Erratum in:
Br J Dermatol. 2010 Apr;162(4):907-8. Dosage error in article text.
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 >or= 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.
PMID: 19995366 [PubMed - indexed for MEDLINE]