Protocol Number: 01-C-0067
HIV-positive patients 13 years of age or older with Kaposi's sarcoma may be eligible for this study. Candidates will have a medical history, physical examination, blood and urine tests, electrocardiogram, chest X-ray and biopsy of a KS lesion (removal of a small piece of tumor tissue, under local anesthetic, for microscopic examination), and possibly other tests. Patients with a history of heart disease may also have a MUGA test (nuclear medicine test of the heart). Participants will receive Doxil infusions intravenously (through a vein) for up to 6 doses once every 3 weeks. They will also receive IL-12 twice a week, injected under the skin. IL-12 injections will continue for up to 3 years, as long as the drug shows benefit and is well tolerated. (Patients will be taught to give themselves the injections.) Pictures of the patient's entire body-focusing on the KS lesions- will be taken when they enter the study, then every 3 weeks while taking Doxil and IL-12, and then once every 8 weeks while receiving IL-12 alone. Participants will be evaluated in the clinic once a week for the first 6 weeks of therapy, then every 3 weeks until the last dose of Doxil, and monthly thereafter. They will be asked about side effects of treatment and may have a physical examination. KS lesions will also be measured. A chest X-ray and blood tests to measure CD4 cells and HIV viral load will be done every 9 weeks while on Doxil with IL-12 and then every 8 weeks while on IL-12 alone. KS lesions will be biopsied before starting drug treatment, at week 9 of treatment, and when the lesions have responded sufficiently for the disease to be considered in partial remission. Patients may be asked to undergo additional skin biopsies for research purposes. Also at the beginning of the study, at week 12 and at week 24, patients will undergo three noninvasive procedures to determine blood vessel density and blood flow in skin areas affected by KS. They are Doppler imaging, which uses a low power laser beam to measure blood flow through the vessels; multi-spectral imaging, which uses a light instrument that can estimate total blood volume and oxygen content; and infrared thermal imaging, which uses a special camera to produce a picture of the temperature of KS lesions in order to assess blood flow. If medically indicated, patients may undergo additional procedures such as computed tomography (CT) or magnetic resonance imaging (MRI) scans. The first 10 patients enrolled in the study will also be asked to have intensive blood sampling once every 2 to 6 hours for 24 hours in order to determine blood levels of IL-12 of and other substances affected by IL-12. A small catheter will be placed in an arm vein to draw the samples in order to avoid repeated needle sticks.
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