Paclitaxel as first or second line treatment for Kaposi's sarcomas: A retrospective study from the north-east of Morocco

Abstract

Author(s): Mohammed Ismaili*, Khaoula Alaoui Ismaili, Imane Stitou, Oumaima Siyouri, Mohammed Ait Raisse, Nawal Hammas, Nawfel Mellas and Samia Arifi

Introduction: Paclitaxel has recently been approved for AIDS-related Kaposi's Sarcoma (KS) and there is much interest also in HIV-negative KS. In our study we aimed to report the activity and safety data of paclitaxel from a cohort of patients from the north east of Morocco.

Patients and Methods: A retrospective analysis of our departmental database from January 2010 to December 2018 was performed. Histologically proven KS cases were recorded. Patients, tumour characteristics, treatment and outcome were analysed.

Results: 16 patients were identified. KS represents 0,13% of all oncology admissions. The mean age at diagnosis was 67 years (+/-17,8) with a sex ration of 3:1. Among these patients 14 had a classic KS, and 2 were HIV-positive. The most common primary site was the lower limbs (50%). The involvement of lymph nodes, mucosa, and/or visceral organs has been registered in 31, 25%, 12,5%, and 37,5% respectively. There were 13 disseminated stage IV patients and 3 stage III. 4 patients underwent radiotherapy. 6 patients received intravenous paclitaxel 100 mg weekly as first-line treatment, whereas 3 received paclitaxel as second line treatment after failure of other regimens (Bleomycin (B), doxorubicin (A), or ABV (V=Vinblastine). Most common side effects were grade 1-2 neutropenia, anaemia, and asthenia. 8/9 patients were evaluable, 6/8 patients achieved a PR, one CR, and one SD. No PD was observed under paclitaxel after a median follow-up of 27 months, while 40 % of patients treated with other regimens relapsed after a mean of 11,5 (+/- 7,85) months.

Conclusion: KS is a very rare disease in the north east of Morocco. Classic type is the most common. Low dose weekly Paclitaxel seems to be effective as a first line chemotherapy and second line as well, for both classic and HIV- positive form, with a very good toxicity profile.

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