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NLM AIDSLINE
Randomized phase III trial of liposomal daunorubicin versus doxorubicin, bleomycin, and vincristine in AIDS-related Kaposi's sarcoma.
Gill PS; Wernz J; Scadden DT; Cohen P; Mukwaya GM; von Roenn JH; Jacobs
November 30, 1996
J Clin Oncol. 1996 Aug;14(8):2353-64. Unique Identifier : AIDSLINE

PURPOSE: To compare the safety and efficacy of liposomal daunorubicin (DaunoXome; NeXstar Pharmaceuticals, Inc, Boulder, CO) with a reference regimen of doxorubicin, bleomycin, and vincristine (ABV) in advanced AIDS-related Kaposi's sarcoma (KS). PATIENTS AND METHODS: In a prospective randomized phase III trial, 232 patients were randomized to receive DaunoXome 40 mg/m2 or a combination regimen of doxorubicin 10 mg/m2, bleomycin 15 U, and vincristine 1 mg, administered intravenously every 2 weeks. Treatment was continued until complete response (CR), disease progression, or unacceptable toxicity. RESULTS: Of 232 patients randomized, 227 were treated: 116 with DaunoXome and 111 with ABV. The overall response rate (CR or partial response [PR]) was 25% (three CRs and 26 PRs) for DaunoXome and 28% (one CR and 30 PRs) for ABV. The difference in response rates was not statistically significant. The median survival time was 369 days for DaunoXome patients and 342 days for ABV patients (P = .19). The median time to treatment failure was 115 days for DaunoXome and 99 days for ABV (P = .13). ABV patients experienced significantly more alopecia and neuropathy (P < .0001). DaunoXome patients experienced more grade 4 neutropenia (P = .021). Cardiac function remained stable, with no instances of congestive heart failure on either treatment arm. CONCLUSION: In this large phase III trial, the efficacy of DaunoXome was comparable to that of ABV. Response rates, time to treatment failure, and overall survival were similar on both treatment arms. DaunoXome is a safe and effective primary therapy for advanced AIDS-related KS.

Acquired Immunodeficiency Syndrome/*COMPLICATIONS Adult Alopecia/CHEMICALLY INDUCED Antibiotics, Anthracycline/*ADMINISTRATION & DOSAGE/ADVERSE EFFECTS/THERAPEUTIC USE Antineoplastic Agents, Combined/ADVERSE EFFECTS/*THERAPEUTIC USE Bleomycin/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS Canada Comparative Study Daunorubicin/*ADMINISTRATION & DOSAGE/ADVERSE EFFECTS/THERAPEUTIC USE Doxorubicin/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS Drug Carriers Female Human Liposomes Male Middle Age Neutropenia/CHEMICALLY INDUCED Prospective Studies Remission Induction Sarcoma, Kaposi's/*DRUG THERAPY/ETIOLOGY/MORTALITY Support, Non-U.S. Gov't Survival Rate Treatment Failure United States Vincristine/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS CLINICAL TRIAL CLINICAL TRIAL, PHASE III JOURNAL ARTICLE MULTICENTER STUDY RANDOMIZED CONTROLLED TRIAL

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