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20 March 2026
Classic Kaposi Sarcoma: Modern Management and Future Horizons
Our review aims to help practitioners tailor therapy according to disease burden and patient characteristics despite the lack of level I evidence in this field
A comprehensive review by Rambam researchers outlines the current treatment landscape and promising new therapies for Classic Kaposi Sarcoma.
A new clinical review led by RTICC members Prof. Alona Zer and Dr. Emily Avitan-Hersh from the Rambam Health Care Campus and the Rappaport Faculty of Medicine at the Technion, highlights the evolving strategies for managing Classic Kaposi Sarcoma (CKS). Published in the journal Cancers, the study provides a vital roadmap for clinicians and researchers, bridging the gap between traditional treatments and next-generation precision medicine for this rare vascular tumor.
Understanding a Complex Disease
Classic Kaposi Sarcoma is a unique type of cancer that typically affects the skin of the lower extremities in older individuals, particularly those of Mediterranean, Eastern European, or Jewish descent. While often characterized by slow-growing purple or brown skin lesions, the disease is complex because it is inextricably linked to the Human Herpesvirus-8 (HHV-8). The review explains that while many patients have a mild clinical course, others may suffer from significant complications like severe swelling (lymphedema) or internal organ involvement, requiring a highly personalized approach to care that balances disease control with quality of life.
From Local Care to Systemic Breakthroughs
For many years, treatment for CKS relied on local interventions such as surgery, radiation, or topical gels. However, the Technion team details how the field is shifting toward systemic therapies for advanced cases. The review discusses the established role of chemotherapy but places a significant emphasis on the arrival of targeted therapies. These newer drugs work by interfering with specific biological pathways—such as those involving blood vessel growth (VEGF) or cell cycle regulation (CDK4/6 inhibitors)—that the virus uses to drive cancer progression, offering more focused alternatives to traditional "broad-spectrum" treatments.
The Rise of Immunotherapy and Future Directions
Perhaps the most exciting frontier discussed is the role of immunotherapy. Since CKS is a virus-driven tumor, the immune system plays a crucial role in its suppression. The authors highlight how "immune checkpoint inhibitors," which "unmask" cancer cells to the immune system, are showing remarkable promise in clinical trials. By synthesizing the latest data, the researchers emphasize that the future of CKS treatment lies in moving away from a "one-size-fits-all" model toward a precision-based strategy that considers the unique viral and immune profile of each patient.
Future Perspectives: Toward a Manageable Chronic Disease
Looking ahead, the therapeutic landscape for CKS is shifting toward a “chemo-sparing” paradigm. The researchers identify a critical unmet need for oral, low-toxicity agents that are safe for long-term use in elderly patients who often manage multiple health conditions. Future research is expected to move beyond data extrapolated from HIV-associated cases to focus on CKS-specific cohorts. By targeting the tumor microenvironment and identifying genetic predispositions, such as the BPTF mutation, the goal is to transform CKS into a manageable chronic disease. Furthermore, defining the optimal duration of therapy remains a key challenge, with a trend toward intermittent "disease control" rather than continuous, high-intensity treatment.
The Review has been published in the Journal Cancers
