Randomized, Comparative Trial of DOX-SL (Stealth Liposomal Doxorubicin Hydrochloride) Versus Bleomycin and Vincristine in the Treatment of AIDS-Related Kaposi's Sarcoma

Inclusion Criteria Concurrent Medication: Allowed: Prophylaxis for PCP, cryptococcal, and herpes infections, and antiretroviral therapy (e.g., AZT, ddC, ddI) provided these doses have been stable for at least 1 month. Maintenance therapy for tuberculosis, fungal, and herpes infections. Therapy for new episodes of tuberculosis, fungal, and herpes infection except with potentially myelotoxic chemotherapy. Foscarnet for cytomegalovirus infection. Erythropoietin. Patients must have: Biopsy-proven, progressive, AIDS-related Kaposi's sarcoma, with any of the following: At least 15 mucocutaneous lesions. Six or more new lesions in the prior month. Documented visceral disease with at least five accessible cutaneous lesions. Documented anti-HIV antibody. No active opportunistic infection with mycobacteria, cytomegalovirus, toxoplasma, Pneumocystis carinii, or other microorganisms (if REQUIRING treatment with myelotoxic drugs). Life expectancy > 4 months. NOTE: Patients who fail the BV combination or who relapse are eligible to enter the Liposome Technology open trial using DOX-SL alone. Exclusion Criteria Co-existing Condition: Patients with the following symptoms or conditions are excluded: Clinically significant cardiac disease. Confusion, disorientation, CNS symptoms, or peripheral neuropathy. Concurrent Medication: Excluded: Other cytotoxic chemotherapy. Colony-stimulating factors. Ganciclovir. Patients with the following prior conditions are excluded: Prior neoplasms treated with extensive chemotherapy that, in the investigator's opinion, has led to irreversibly compromised bone marrow function. History of idiosyncratic or allergic reaction to anthracyclines, bleomycin, or vincristine. History of major psychiatric illness. Prior Medication: Excluded: Cytotoxic chemotherapy or interferon therapy within the past 4 weeks. More than one prior cycle of bleomycin/vincristine at any time. Prior Treatment: Excluded: Radiation or electron beam therapy within the past 3 weeks.