Bower and colleagues1 recently reported results of a prospectively-applied management strategy for newly-diagnosed Kaposi sarcoma (KS) in people living with HIV (PLWH) presenting to their center in London. Their approach, which emphasized optimization of combination antiretroviral therapy (cART) in all patients, and use of systemic liposomal anthracycline chemotherapy only for advanced-stage (T1) tumors, resulted in excellent overall survival, although approximately one-quarter of patients with limited-stage (T0) KS treated with cART alone eventually showed KS progression.

In an accompanying editorial, Krell and Stebbing2 recommended that the same, stagestratified approach yielding good outcomes when applied as a (non-randomized) strategy at a single site in a high-resource setting be adopted globally, and that if cost and chemotherapy-related infrastructural barriers could be overcome, pegylated liposomal doxorubicin (PLD) should be made available for all patients with advanced-stage KS in sub-Saharan Africa (SSA), where the world's burden of HIV-associated KS is concentrated. As