Case report

Molecularly targeted therapy for Kaposi's sarcoma in a kidney transplant patient: case report, "what worked and what did not"

Patricia Volkow¹ , Juan W Zinser² and Ricardo Correa-Rotter³

¹  Infectious Diseases Department, Instituto Nacional de Cancerología, San Fernando 22, México DF 14050, México

²  Medical Oncology Division, Instituto Nacional de Cancerología, San Fernando 22, Mexico DF 14050, Mexico

³  Department of Nefrology and Mineral Metabolisim, Instituto Nacional de las Ciencias Médicas y la Nutrición Salvador Zubirán, Vasco de Quiroga 15, Mexico DF 14000, Mexico

author email corresponding author email

BMC Nephrology 2007, 8:6doi:10.1186/1471-2369-8-6

Published:	27 March 2007

Abstract

Background

Imatinib is a tyrosine-kinase inhibitor; for which there is limited information regarding its effects on AIDS Kaposi's sarcoma and none in patients with transplant-associated Kaposi's sarcoma. Sirolimus, an immunosuppressive drug used for kidney transplant, exhibits antiangiogenic activity related to impaired production of VEGF (vascular endothelial growth factor), clinical benefit has been reported in Kaposi's sarcoma associated with renal graft.

Case Presentation

Here we report a case of an 80 year old male, who developed Kaposi's Sarcoma nine months after receiving a living non-related donor kidney transplant at age 74. Three years after treatment with different chemotherapeutic agents for progressive cutaneous Kaposi's Sarcoma with no visceral involvement, he was prescribed Imatinib (200 mg/day for two weeks followed by 400 mg/day) after four weeks of treatment he developed anasarca, further progression of KS and agranulocytosis. Imatinib was discontinued and there was significant clinical recovery. One year later his immunosuppressive therapy was changed to Sirolimus and regression of the Kaposi's sarcoma occurred.

Conclusion

The lack of benefit and severe toxicity associated with the use of Imatinib in this patient should alert clinicians of potentially adverse consequence of its use in patients with transplant associated Kaposi's sarcoma. On the other hand the positive response seen in this patient to Sirolimus even after a long evolution of Kaposi's sarcoma, multiple chemotherapy regimens and extensive cutaneous disease further suggest it therapeutical utility for transplant associated Kaposi's sarcoma.