Antiangiogenic agents

Thalidomide is an anti-angiogenic agent that has been investigated in uncontrolled phase II trials in the treatment of AIDS-related KS. One such study of 20 patients, of whom 17 were assessable for response, reported a 40% (8/20) partial response rate with oral thalidomide, 200 mg/day, increased fortnightly to a maximum of 1000 mg/day.69 Response lasted for a median of 7-1 months and the median thalidomide dose at the time of maximum response was 500 mg/day. Nine of 20 patients experienced drowsiness and seven patients experienced depression. Five patients withdrew from the study because of toxicity.69 In another uncontrolled study, 17 patients with AIDS-related KS were given oral thalidomide, 100 mg at night for 8 weeks; 35% patients (6/17) had a partial response but six patients withdrew early because of toxicity.70 The highly vascular nature of KS has produced interest in other anti-angiogenic agents such as matrix metalloproteinase inhibitors, which are being investigated in phase I studies.

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