First-Line Treatment for Kaposi Sarcoma

First-Line Treatment for Kaposi Sarcoma: A Complete Guide

Cancer cells that cover the blood vessels or lymph vessels cause Kaposi sarcoma. It most often occurs when human herpesvirus 8 (HHV-8) is present, and it mainly affects people with weak immune systems, such as those infected with HIV/AIDS. This type of cancer may form as skin lesions, inside the mouth, in lymph nodes, or in internal organs.

What are the Different Types of Kaposi Sarcoma?

There are four main types of Kaposi sarcoma:

● Epidemic (AIDS-associated)

● Classic (affecting older men of Mediterranean or Eastern European descent)

● Endemic (African)

● Iatrogenic (transplant-related)
 

Can Kaposi Sarcoma be Treated?

Most people think that Kaposi sarcoma is treatable, but not because there is a cure for it, since HHV-8 does not get fully cleared from the body. After treatment, it is essential to continue monitoring the patient, as the lesions can recur if the immune system weakens again.

First-Line Treatment for Kaposi Sarcoma

Physicians decide the initial treatment based on the cancer subtype, the patient’s comorbidities, and the strength of their immune system.

1. HIV-Associated (Epidemic) Kaposi Sarcoma

Epidemic Kaposi sarcoma, the most common form of this disease, affects individuals infected with HIV. For individuals with HIV, Kaposi sarcoma is an AIDS-defining illness. Achieving good control of the HIV infection itself with antiretroviral therapy (ART) is the cornerstone of treatment and often leads to the regression or stabilization of KS lesions.

● Antiretroviral Therapy

HIV-related Kaposi sarcoma is treated first by making sure that people have or begin combination antiretroviral therapy (cART). ART works by decreasing the amount of HIV, increasing the immune system’s activity, and generally making lesions either disappear or remain stable.

● Chemotherapy

Physicians may include chemotherapy and ART for patients who have diseases that spread to the internal organs or those with severe and fast-growing cancer. Also, paclitaxel is used when liposomal treatment is not possible.
 

2. Classic Kaposi Sarcoma

Usually, this form of Kaposi sarcoma progresses slowly and occurs on the skin of the legs and feet. It is a slow-growing sarcoma which usually appears as red, pink or asymptomatic purple lesions on the skin.

● Local Treatment

If the signs of the disease are mild and there are few symptoms, just observing the condition may be enough. Healthcare providers may treat the patient without requiring hospital admission. However, when the tumour appears as a single lesion, they often perform cryotherapy or surgical excision.

● Systemic Therapy

When symptoms become more prominent, the patient should be put under systemic therapy. Doctors administer oral etoposide or intravenous vinblastine for chemotherapy. Additionally, they recommend pegylated liposomal doxorubicin for patients with numerous extremely painful lesions.

3. Endemic Kaposi Sarcoma

HIV-positive people and those who are HIV-negative can experience endemic Kaposi sarcoma. It is also common in children and requires immediate treatment.

1. HIV-Positive Patients: ARVs and chemotherapy are often used to treat this disease.
2. HIV-Negative Patients: Chemo with liposomal anthracyclines is usually given to treat aggressive forms of the illness. A child with aggressive endemic KS may receive a treatment plan specially made for them, which often includes chemotherapy regimens like vincristine or liposomal anthracyclines.

4. Iatrogenic Kaposi Sarcoma

This type of sarcoma most often affects people who are on immunosuppressive drugs after receiving an organ transplant.

• Reducing Immunosuppression: Usually, the initial treatment is to lower the amount of immunosuppressive drugs. Physicians administer chemotherapy systemically for severe or advanced cancer if reducing immunosuppression does not produce the desired results.
   

Treatment Outcomes of Kaposi Sarcoma

In most cases, healthcare providers can address and control Kaposi sarcoma effectively if they detect it early or manage the patient’s immune system issues. Reacting quickly to the infection with HIV-ART usually brings major improvements in Kaposi sarcoma signs. Nevertheless, needing immunosuppressive drugs may lead to needing constant check-ups.

Many patients diagnosed with classic Kaposi sarcoma are not very active, and several of them can live for years with few symptoms or treatments. In endemic Kaposi sarcoma, some kids do well, while others with severe symptoms may not do well unless they receive proper medical care.

Other Therapies and Helpful Services for Kaposi Sarcoma

The following line of treatment can also be used to treat Kaposi sarcoma:

1. Localised Treatments

They may treat small skin lesions with the topical therapy alitretinoin gel. In intralesional chemotherapy, they inject the medicine directly into the tumour—for example, vincristine for an isolated lesion.

2. Emerging Treatments

Kaposi sarcoma doctors are studying the use of checkpoint inhibitors (such as pembrolizumab) in cases where other treatments have stopped working. Moreover, drugs that lessen angiogenesis or suppress HHV-8 replication are currently under research.

3. Supportive Care

Patient care should include relieving pain, giving psychological support, and managing lymphoedema. Providing the right diet and managing infections in people with a weakened immune system

The approach to Kaposi sarcoma treatment at the beginning mainly relies on the type of Kaposi sarcoma, the patient’s immune system, and the severity of the condition. The most basic treatment is antiretroviral drugs. However, physicians sometimes use chemotherapy if the symptoms are too severe.