Kaposi sarcoma
Prepared with OnCo (onco.cc/prep/kaposi-sarcoma/). Orientation, not medical advice; your team knows your case.
My details
What I know, what is unclear, changes to discuss
Saved in this browserMy questions
18 on the sheet- 1.What is my exact diagnosis, stage, and grade, and which tests established them?
- 2.Which biomarkers have been tested on my tumour (for example HHV-8 LANA-1 immunohistochemistry, HIV status, CD4 count, viral load, ACTG TIS staging, KSHV viral load, Visceral involvement), and what were the results?
- 3.Which subtype is my cancer, and does that change the recommended treatment?
- 4.Is germline (inherited) genetic testing recommended for me or my family?
- 5.For my situation (aids-ks, limited (t0)), which of the standard options do you recommend and why?
- 6.For my situation (aids-ks, advanced (t1) or symptomatic), which of the standard options do you recommend and why?
- 7.Am I a candidate for Pegylated liposomal doxorubicin, Paclitaxel / nab-paclitaxel, Pomalidomide, and what side effects should I expect?
- 8.For my situation (classic or hiv-negative ks), which of the standard options do you recommend and why?
- 9.Am I a candidate for Pegylated liposomal doxorubicin, Paclitaxel / nab-paclitaxel, Pomalidomide or related drugs, and what side effects should I expect?
- 10.For my situation (iatrogenic ks), which of the standard options do you recommend and why?
- 11.Am I a candidate for Everolimus, and what side effects should I expect?
- 12.For my situation (resource-limited settings), which of the standard options do you recommend and why?
- 13.Am I a candidate for Paclitaxel / nab-paclitaxel, Bleomycin, Vincristine, and what side effects should I expect?
- 14.Are there clinical trials I could join, for example of Pomalidomide, Pembrolizumab, Nivolumab?
- 15.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
- 16.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
- 17.I read that “Access to effective chemotherapy and ART-linked cancer care in sub-Saharan Africa”. How does that affect my plan?
- 18.I read that “KS in people with suppressed HIV and normal CD4 counts (unexplained)”. How does that affect my plan?
The words I may hear
- Immune-related adverse events (irAEs): Immune-related adverse events (irAEs) are the autoimmune side effects of checkpoint inhibitors: colitis, thyroid problems, rash, hepatitis, pneumonitis.
Tests and results to bring
Biomarker results to ask for: HHV-8 LANA-1 immunohistochemistry, HIV status, CD4 count, viral load, ACTG TIS staging (tumour, immune, systemic), KSHV viral load (KICS, MCD), Visceral involvement (endoscopy, imaging).
Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.
The treatments I may be offered
- AIDS-KS, limited (T0): Antiretroviral therapy; observe for regression (watch for IRIS-KS flare); local therapy for cosmetically or functionally important lesions. (IMRT / IGRT (modern external beam))
- Resource-limited settings: ART plus paclitaxel where available (ACTG A5263); bleomycin-vincristine otherwise; task-shifted oncology nursing models. (Paclitaxel / nab-paclitaxel, Bleomycin, Vincristine)
- AIDS-KS, advanced (T1) or symptomatic: ART plus pegylated liposomal doxorubicin (preferred) or paclitaxel; pomalidomide as an oral option; continue until maximal response. (Pegylated liposomal doxorubicin, Paclitaxel / nab-paclitaxel, Pomalidomide)
- Classic or HIV-negative KS: Local radiotherapy, intralesional vincristine or cryotherapy for few lesions; pegylated liposomal doxorubicin, paclitaxel or pomalidomide for extensive disease. (Pegylated liposomal doxorubicin, Paclitaxel / nab-paclitaxel, Pomalidomide, Vincristine)
- Iatrogenic KS: Reduce immunosuppression; switch calcineurin inhibitor to sirolimus/everolimus; chemotherapy if progressive. (Everolimus)
From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.