KAPOSI'S SARCOMA AND AIDS: THE ROLE OF INTERFERONS IN TREATMENT

Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.

KAPOSI'S SARCOMA AND AIDS: THE ROLE OF INTERFERONS IN TREATMENT

Dev Med Virol; 4:62-74 1988. Unique Identifier : AIDSLINE ICDB/89649847
Krown SE; Memorial Sloan-Kettering Cancer Center, 1275 York Ave., New York,; NY 10021

Abstract: The role of interferons (IFNs) in the treatment of Kaposi's sarcoma (KS) is reviewed and the potential role of IFNs in the treatment of opportunistic infections associated with AIDS is discussed. Results of the author's initial trial, in which 5/12 patients (pts) with AIDS-associated KS responded to daily im doses of 36-54 million units of IFN-alpha2a, were later confirmed in larger trials and by others investigating IFN-alpha2b and IFN-alphaN1. Overall, when given in doses of 20 million units or more/m2 of body surface, the mean objective response rate has been approx 30%. The clinical features most consistently associated with poor response to IFN-alpha have included a history of prior opportunistic infection and the presence of systemic 'B' symptoms (wt loss, fever, night sweats). Pts with relatively preserved immune function respond more frequently to IFN-alpha, but it is unclear whether the improved prognosis is the result of IFN therapy or the result of individual characteristics of these pts that would have led to a more favorable course of disease regardless of therapy. Preliminary trials with IFN-gamma showed no significant antitumor activity against KS. However, IFN-gamma has been shown to stimulate the oxidative metabolism of human mononuclear phagocytes, suggesting that IFN-gamma may have a potential role in the treatment or prevention of some of the infectious complications of AIDS. IFN's role in the treatment of HIV infection is also being investigated. IFN-alpha inhibits HIV replication. Azidothymidine and IFN-alpha2a synergistically suppress in vitro HIV replication, suggesting that combination therapy with these agents might affect both the underlying cause of AIDS and its neoplastic complication. (62 Refs)

Keywords: Acquired Immunodeficiency Syndrome/COMPLICATIONS/THERAPY Clinical Trials Dose-Response Relationship, Drug Human Interferon Alfa-2b/THERAPEUTIC USE Interferon Type I/THERAPEUTIC USE Interferon-gamma, Recombinant/THERAPEUTIC USE Interferons/*THERAPEUTIC USE Sarcoma, Kaposi's/COMPLICATIONS/*THERAPY Skin Neoplasms/COMPLICATIONS/*THERAPY CLINICAL TRIAL JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL

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