Pegylated-Liposomal Doxorubicin (Doxil®) in the Treatment of AIDS-Related Kaposi’s Sarcoma

In 1981 reports of the development of Kaposi’s sarcoma in previously healthy young homosexual men heralded the onset of the epidemic of acquired immunodeficiency syndrome (AIDS). 1–3 Kaposi’s sarcoma is the most common neoplasm in persons infected with the human immunodeficiency virus (HIV), having been the initial (“AIDS-defining”) diagnosis in 15% of the patients with AIDS in the United States.4 It has been estimated that AIDS-related Kaposi’s sarcoma (AIDS-KS) has a prevalence of about 20,000 cases in this country.5 While the overall incidence seems to be declining, the actual morbidity and mortality ascribed to AIDS-KS has increased, probably as a result of improved therapy of opportunistic infections without concurrent improvements in the treatment of AIDS-KS.6,7 Several modalities have been employed successfully to treat AIDS-KS, but their toxicities, as well as the patients’ underlying immunodeficiency, have limited their usefulness. Also, AIDS-KS produces visceral involvement, especially in the lungs, for which current treatments are less effective than for cutaneous disease. 8,9