Sarcoma

Kaposi’s sarcoma (KS) is an AIDS-defining neoplasm characterized by the development of lesions that histologically consist of proliferating spindle cells, vascular channels, and inflammatory cells.[1] The typical early presentation consists of painless pink, red, or purple macules or nodules on the skin surface or in the oral cavity. Although the presence of a few skin lesions is not life-threatening, even limited cutaneous KS can have an enormous psychosocial impact, particularly when the lesions occur on exposed areas.

Uterine sarcomas arise from the uterine muscle (leiomyosarcoma) or endometrial glands and stroma (endometrial stromal sarcoma and carcinosarcoma). They account for about 3% of all uterine malignancies and less than 1% of all gynecologic malignancies. Uterine sarcomas have differing etiologies, clinical courses, and pathologic features, which give rise to variable treatment regimens and clinical outcomes. The leiomyosarcomas and (malignant) mixed mullerian tumors (M/MMT or carcinosarcomas) have a higher rate of occurrence in black than in white females. Carcinosarcomas are unusual before the age of 40 and have rising incidence with advancing age, while leiomyosarcomas have peak incidence between ages 35 and 55 for blacks and ages 40 and 50 for whites. The development of sarcomas also appears to be increased by previous pelvic radiation, especially the carcinosarcomas and adenosarcomas.

Anthracycline antibiotic use is limited by cardiac toxicity. The risk factors are cumulative dose, radiation to the chest and mediastinum, age, and preexisting myocardial impairment. Dexrazoxane (Zinecard) can prevent

BETHESDA, Md-For the second time in as many meetings, the Oncologic Drugs Advisory Committee (ODAC) has recommended that the FDA approve a paclitaxel-based drug for the treatment of AIDS-related Kaposi’s sarcoma (KS).

The treatments employed for Kaposi’s sarcoma in patients with acquired immunodeficiency syndrome (AIDS-KS) have been limited in their usefulness by toxicities and underlying immunodeficiency in this patient population.

ROCKVILLE, Md-The Food and Drug Administration (FDA) has cleared Bristol-Myers Squibb’s Taxol (paclitaxel) Injection for use in the second-line treatment of AIDS-related Kaposi’s sarcoma (KS). Taxol is also approved for second-line use in metastatic breast and ovarian cancer.

The Society of Surgical Oncology surgical practice guidelines focus on the signs and symptoms of primary cancer, timely evaluation of the symptomatic patient, appropriate preoperative evaluation for extent of disease, and role of the surgeon in diagnosis and treatment. Separate sections on adjuvant therapy, follow-up programs, or management of recurrent cancer have been intentionally omitted. Where appropriate, perioperative adjuvant combined-modality therapy is discussed under surgical management. Each guideline is presented in minimal outline form as a delineation of therapeutic options.

BETHESDA, Md--The FDA's Oncology Drugs Advisory Committee (ODAC) voted 8 to 4 to recommend that the agency grant traditional new drug approval to Bristol-Myers Squibb's Taxol for Injection Concentrate (paclitaxel) for the second-line treatment of AIDS-related Kaposi's sarcoma (KS).

BETHESDA, Md--Thalidomide, paclitaxel (Taxol), and vinorelbine (Navelbine) have all shown promise in phase II trials as treatment for Kaposi's sarcoma in AIDS, researchers reported at the National AIDS Malignancy Conference. Although progress has come in treating KS, more effective drugs are needed, especially in light of the lengthening life span emerging for AIDS patients from the use of drug combinations.

CHICAGO--In feasibility testing, a custom-designed high-dose-rate contact radiation therapy technique destroyed Kaposi's sarcoma on the hard palate in less time than conventional external beam radiotherapy and with less severe side effects.

SEATTLE--Studies are underway using high-dose chemotherapy followed by autologous hematopoietic stem cell transplant for the treatment of neuroblastoma, Ewing's sarcoma, and other solid tumors in children, Julie Park, MD, of Children's Hospital and Medical Center, Seattle, said at the Association of Pediatric Oncology Nurses meeting.

Soft-tissue sarcomas arising in the retroperitoneum represent an uncommon diagnosis, with approximately 600 new cases per year in the United States. Due to this small database, an assessment of the relative merits of different treatment strategies is not available. It is known is that patients with retroperitoneal sarcomas fare worse in terms of local control and disease-free survival than do patients with soft-tissue sarcoma of an extremity. The reasons for this are unclear but may be due, in part, to the large size of these tumors at diagnosis and the difficulty in obtaining adequate surgical margins.

Historically, patients with retroperitoneal sarcomas have had a poor prognosis. Surgical resection continues to be the standard treatment for these tumors. However, their anatomic location and large size at presentation often

VANCOUVER, BC--The discovery in 1994 of a new human herpesvirus associated with Kaposi's sarcoma (KS) brought some order to the previously contentious discussion about causes of the disease in patients with HIV. Researchers at the 11th International Conference on AIDS further nailed human herpesvirus-8 (HHV-8, also known as Kaposi's sarcoma-associated herpesvirus or KSHV) as the culprit in many, if not most, cases of KS (see also, page 1).

VANCOUVER, BC--Human herpesvirus-8 (HHV-8), also known as Kaposi's sarcoma-associated herpesvirus or KSHV, appears to be linked to the development not only of Kaposi's sarcoma (KS) but also to a newly identified type of AIDS lymphoma, Alexandra Levine, MD, said at an educational symposium at the 11th International Conference on AIDS.

As many as 40% of individuals infected with HIV will be diagnosed with a malignancy during the course of their illness. Although neoplasms of all organ systems have been reported in infected patients, Kaposi's sarcoma (KS),

VANCOUVER, BC--Discussions of Kaposi's sarcoma at the 11th International Conference on AIDS included reports on a promising topical treatment, photodynamic therapy (PDT), a chemotherapy regimen that could save up to $1,000 per course, and the possibility of prevention using antiherpes drugs.

Prior to 1981, Kaposi sarcoma (KS) was considered a rare human cancer occurring primarily among elderly Italian and Jewish men of eastern European ancestry. I wrote a review of KS research and clinical experiences that appeared in CA: A

Major investigative studies have yielded considerable data on various aspects of Kaposi's sarcoma (KS), including cellular and molecular events leading to the development of HIV-associated KS, histopathologic features, clinical

Inflammatory cytokines plus the human immunodeficiency virus Tat protein apparently trigger the development of early Kaposi's sarcoma. Activated spindle cells provide a self-perpetuating, autocrine-supported mechanism for further development of hyperplastic lesions. In more advanced stages, a true neoplastic process may develop. [ONCOLOGY 10(Suppl):34-36, 1996]

The unique epidemiology of Kaposi's sarcoma among patients with the acquired immunodeficiency syndrome suggests a multifactorial cause. Although the human immunodeficiency virus (HIV) plays a major role in the

In the early 1980s, we first began to see cases of Kaposi's sarcoma (KS) in patients with the lymphadenopathy now known to be associated with infection by the human immunodeficiency virus (HIV). During that period, we

Treatment options for patients with acquired immune deficiency syndrome (AIDS)-related Kaposi's sarcoma (KS) have changed very little over the past decade. Research has been hampered by the absence of an accepted

BOULDER, Colorado--NeXstar Pharmaceuticals, Inc., has launched DaunoXome, its liposomal dauno-rubicin product, as first-line treatment for advanced HIV-associated Kaposi's sarcoma (KS).

BOULDER, Colorado--NeXstar Pharmaceutical's DaunoXome (dauno-rubicin citrate liposome injection) has received FDA approval for use as primary therapy for advanced HIV-associated Kaposi's sarcoma (KS).

WASHINGTON--In an update of its 1994 report, the Institute of Medicine (IOM), of the National Academy of Sciences, has confirmed its original findings of an association between herbicides used in the Vietnam War and various health problems, namely, soft tissue sarcoma, non-Hodgkin's lymphoma, Hodgkin's disease, and chloracne.

Combined treatment involving surgery and radiotherapy is a reasonable alternative to surgery alone in high-risk patients with dermato-fibrosarcoma protruberans (DFSP), Canadian researchers reported at the American Society for Therapeutic Radiology and Oncology (ASTRO) meeting.

A study demonstrating the existence of a new transmissible herpesvirus may lead to additional therapeutic approaches for Kaposi's sarcoma (KS), a cancer that remains one of the major AIDS-associated malignancies. The study findings were reported at The American Society of Hematology's 37th Annual Meeting in Seattle.

Our arsenals for fighting off bacteria are so powerful, and involve so many different defense mechanisms, that we are in more danger from them than the invaders. We live in the midst of explosive devices; we are mined.

Emmanoulides, Miles, and Mitsuyasu have written an excellent review summarizing our current understanding of the pathogenesis of AIDS-related Kaposi's sarcoma (AIDS/KS). The authors cover what is currently well established and also provide their viewpoint on future developments in AIDS/KS. My commentary will highlight some of the major questions related to this complex disease.