• Bleomycin is active against KS, although it appears to be more effective in combinations than as a single agent.
Responses to it as a single agent appear to be short, but very little blood count depression occurs.
• Methotrexate is similarly active, and ways can be found to give it with little blood count depression. Its use is
limited, however, because it can cause rather marked blistering of the mouth.
• Among the new agents being tested are drugs related to Retin-A, an anti-wrinkle drug.
Combination Chemotherapy In the early days of AIDS, combinations of chemotherapy drugs were nearly always used. They fell into disfavor because of the high death rate from drug toxicity, often resulting in infections such as pneumocystis pneumonia. With the use of newer drugs such as AZT, inhaled pentamadine and foscarnet and with combination therapy for Mycobacterium avium infections, combinations are being used again, with higher response rates.
Many combinations of all these agents are being studied. Current standard therapy is either of the two Velban-Oncovin programs on a weekly treatment schedule or a combination of Adriamycin , bleomycin and vincristine (Oncovin) (ABV) given every week.
Whenever possible, patients should consider participating in a clinical trial with the hope of improved response and survival. If not in a study, treatment should always be given by a physician experienced in using these agents.
