Vinca alkaloids

We found one randomised study comparing oral etoposide with vinblastine in the treatment of classical KS in elderly Mediterranean patients.46 We found no randomised evidence for the use of single-agent vinca alkaloids in AIDS-related KS. Several uncontrolled phase II studies used single-agent vinblastine in the treatment of both classical and AIDS-related KS.2547-52

In one study, 65 elderly patients with classical KS were randomised between oral etoposide and intravenous vinblastine.46 Etoposide was given every 3 weeks at a dose of 60 mg/m2 on days 1-3 for the first cycle, days 1-4 for the second cycle and days 1-5 for the third cycle. Vinblastine was given intravenously at a dose of 3 mg/m2 weekly for the first 3 weeks then 6 mg/m2 every 3 weeks. The overall response rate was 73% for etoposide and 58% for vinblastine (P = 0-3). An uncontrolled phase II study of single-agent vinblastine in 38 patients with AIDS-related KS reported an overall response rate of 26% with weekly vinblastine, 4-8 mg/week titrated against white blood cell count.49 Reported response rates to vinblastine in small uncontrolled studies are higher for classical KS than for AIDS-related KS.

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