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Chemotherapy (chemo) is the use of drugs to treat cancer. Chemo can be given in 2 ways to treat Kaposi sarcoma (KS).

• Systemic chemotherapy: Chemo drugs injected into a vein (IV) or taken by mouth. These drugs enter your bloodstream to reach almost all areas of your body. This type of treatment can be used to treat cancer that has spread to many areas of the body. It is the type of chemo described on this page.
• Intralesional chemotherapy: Chemo drugs injected directly into a tumor. This is described in Local Treatments for Kaposi Sarcoma.

Which chemo drugs are used to treat KS?

The systemic chemo drugs used most often in the US to treat KS are:

• Liposomal doxorubicin
• Paclitaxel

Other chemo drugs that can be used to treat KS include:

• Nab-paclitaxel
• Gemcitabine
• Vinorelbine
• Etoposide

Doctors give chemo in cycles. A cycle is a period of treatment followed by a period of rest to allow the body time to recover. Each chemo cycle generally lasts for several weeks. Most chemo treatments can be given in the doctor’s office, clinic, or hospital outpatient department.

When is chemo used to treat KS?

Chemo is most often used for KS that is in parts of the body that make it hard to treat with local treatments.

In most people with KS, chemo can shrink the lesions and improve symptoms, but the KS generally doesn’t go away completely. Sometimes chemo can be stopped if the lesions aren’t causing problems or increasing in size and number. If the KS starts to get worse, chemo can be restarted.

Giving chemo carefully to people with KS

Chemo can weaken your immune system. Many people with KS already have weakened immune systems, so doctors try to strike a careful balance between treating the KS lesions and not weakening the immune system further.

If you have KS, it’s also important to try to improve your immune system when possible. This is especially important if you get chemo.

An important part of treatment for people with HIV-related KS is antiretroviral therapy (ART) to treat the HIV infection. This can be given along with chemotherapy, but your doctor will need to take into account possible interactions between the ART and the chemo drugs.

Side effects of chemotherapy

Chemo drugs can cause side effects. These depend on the type of drugs, the dose, and how long treatment lasts.

Common chemo side effects

Common side effects from chemo include:

• Nausea and vomiting
• Loss of appetite
• Mouth sores
• Diarrhea
• Hair loss
• Increased risk of infection, from too few white blood cells
• Easy bruising or bleeding, from too few blood platelets
• Fatigue, from too few red blood cells

Drug-specific side effects

Some chemo drugs used to treat Kaposi sarcoma can have other side effects.

For example, vinorelbine and paclitaxel can damage nerves. This is called neuropathy. It can lead to numbness, tingling, or pain, especially in your fingers and toes. It might also cause some weakness in your arms and legs. These problems tend to be worse in people with AIDS, which can also affect nerve cells.

Preventing or lessening side effects

Most side effects go away once you finish treatment, but some can last a long time or even be permanent. Ask your cancer care team about possible side effects from the chemo drugs you will receive.

There are often ways to prevent or lessen chemo side effects. For example, there are drugs to help with nausea and vomiting. Tell your cancer care team about any side effects or changes you notice while getting chemo so that they can be treated promptly.