Pegylated liposomal doxorubicin in the treatment of AIDS-related Kaposi’s sarcoma

Ashish Udhrain¹, Keith M Skubitz², Donald W Northfelt³

¹Department of Medicine, Mayo Clinic Arizona, AZ, USA; ²Division of Hematology, Oncology, and Transplantation, University of Minnesota, MN, USA; ³Division of Hematology – Medical Oncology, Mayo Clinic Arizona, AZ, USA

Abstract: Kaposi’s sarcoma is a vascular tumor of skin and viscera first described in 1872. Prior to the 1980s, this disease was rarely seen in the Western world, but was quite prevalent in Sub-Saharan African countries. Since the onset of the HIV pandemic in the 1980s, the incidence of Kaposi’s sarcoma has increased markedly in Africa and continues to be a significant problem in association with AIDS in Western countries. Many therapies have been demonstrated to be effective in the treatment of HIV-related Kaposi’s sarcoma, including alitretinoin gel, interferon alpha, and various forms of cytotoxic chemotherapy. Antiretroviral therapy combined with cytotoxic agents has yielded significantly greater efficacy than chemotherapy alone. However, as reviewed in this report, pegylated liposomal doxorubicin has been established as the treatment of choice for patients with AIDS-associated Kaposi’s sarcoma in Western countries. Compelling preclinical and clinical evidence, reviewed herein, has demonstrated that the nanoparticle (pegylated liposome) delivery system of this formulation leads to greater tumor localization of doxorubicin and consequent improved efficacy, as well as reduced toxicity.

Keywords: liposomal doxorubicin, pegylated liposomal doxorubicin, Kaposi’s sarcoma, liposomal daunorubicin, liposomal anthracyclinces