Loading
10 slides generated from the cancer page, with a quiz from the open benchmark and speaker notes that cite the sources. Arrow keys move between slides; Print gives one slide per page.
Kaposi sarcoma is a blood-vessel cancer caused by the herpesvirus HHV-8, made famous by the AIDS epidemic. In people with HIV, antiretroviral therapy alone often shrinks it; liposomal doxorubicin or paclitaxel treat advanced disease, and it remains among the commonest cancers in sub-Saharan Africa, where paclitaxel is often unaffordable.
Kaposi sarcoma is a KSHV/HHV-8-driven vascular tumour with four epidemiologic forms: classic (elderly Mediterranean/Eastern European men, indolent), endemic African (including an aggressive lymphadenopathic childhood form), iatrogenic (transplant immunosuppression), and epidemic (AIDS-associated), plus KS in men who have sex with men with controlled HIV. Lesions involve skin, mucosa, lymph nodes and viscera (lung, gut); KSHV also causes primary effusion lymphoma and multicentric Castleman disease, and KS inflammatory cytokine syndrome (KICS).
AIDS-KS: antiretroviral therapy is the foundation and suffices for limited disease; advanced disease (visceral, oedema, rapid progression, T1 by ACTG staging) adds pegylated liposomal doxorubicin (first line) or paclitaxel, both approved in the 1990s; pomalidomide (2020) was the first new KS drug in two decades and works in HIV-positive and -negative patients. Iatrogenic KS responds to reducing immunosuppression or switching to mTOR inhibitors (sirolimus). Classic KS is treated with local therapy (radiotherapy, intralesional vincristine, cryotherapy) or the same systemic agents. In Africa, where paclitaxel is often unaffordable, bleomycin-vincristine regimens remain in use and ACTG A5263 showed paclitaxel superior to oral etoposide and BV. Immune checkpoint inhibitors show activity in small series.
| Setting | Approach | Guideline |
|---|---|---|
| AIDS-KS, limited (T0) | Antiretroviral therapy; observe for regression (watch for IRIS-KS flare); local therapy for cosmetically or functionally important lesions. | NCCN Category 2A |
| AIDS-KS, advanced (T1) or symptomatic | ART plus pegylated liposomal doxorubicin (preferred) or paclitaxel; pomalidomide as an oral option; continue until maximal response. | NCCN Category 1 (PLD, paclitaxel); 2A (pomalidomide) |
| Classic or HIV-negative KS | Local radiotherapy, intralesional vincristine or cryotherapy for few lesions; pegylated liposomal doxorubicin, paclitaxel or pomalidomide for extensive disease. | NCCN Category 2A |
| Iatrogenic KS | Reduce immunosuppression; switch calcineurin inhibitor to sirolimus/everolimus; chemotherapy if progressive. | not mapped |
| Resource-limited settings | ART plus paclitaxel where available (ACTG A5263); bleomycin-vincristine otherwise; task-shifted oncology nursing models. | not mapped |