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Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

1330 - KS In The Era Of HAART: A Single Institutional Retrospective Review

Date

22 Oct 2018

Session

Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

Topics

Tumour Site

Sarcoma

Presenters

Kamya Sankar

Citation

Annals of Oncology (2018) 29 (suppl_8): viii576-viii595. 10.1093/annonc/mdy299

Authors

K. Sankar1, K. Foster2, C. Achenbach3, M. Agulnik2

Author affiliations

  • 1 Medicine, Northwestern University, 60611 - Chicago/US
  • 2 Hematology/ Oncology, Northwestern University, 60611 - Chicago/US
  • 3 Medicine, Northwestern University, Chicago/US
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Resources

Abstract 1330

Background

Kaposi’s Sarcoma (KS) is an angioproliferative tumor with 4 sub-types: classic (CKS), endemic, immunosuppression related, and epidemic (AIDS-KS). AIDS-KS prevalence has decreased since the introduction of highly active anti-retroviral therapy (HAART). KS lesions develop in patients (pts) with undetectable viral loads and high CD4 counts. KS is variable across subtypes, disease course, and clinical outcomes. Treatments are individualized.

Methods

IRB approval was obtained. A retrospective cohort was identified of KS pts evaluated and treated between 2005 and 2017 at the Lurie Cancer Center, Northwestern University. Pts were identified through the Enterprise Data Warehouse. Pt data was reviewed for demographics, clinical and pathological features and therapy. Descriptive statistics were used to assess disease severity and treatment.

Results

130 pts with a diagnosis of KS were identified, of which 95 (73.1%) had AIDS-KS and 31 (23.8%) had CKS. There were 4 patients with immunosuppression therapy-related KS and no endemic cases. Males represented 91.5% of cases. The mean age at diagnosis was 66.8 years ± 14.4 among CKS pts and 42.1 years ± 9.6 in AIDS-KS pts. 18.9% of AIDS-KS pts had metastatic disease vs. 6.5% in the CKS group. At KS diagnosis, 50.5% of AIDS-KS pts had CD4 count >200 cells/mm3 and 33.7% had HIV viral load level < =20 copies/mL. Among the 53 pts who received chemotherapy, 45 were AIDS-KS pts (84.9%). 65% of pts with metastatic disease (lung or GI involvement) at diagnosis, of which 90% had AIDS-KS, received chemotherapy vs 36.3% of pts with skin/mucosa involvement. The most commonly used chemotherapy was liposomal doxorubicin (78.4%) with an average of 10 cycles. Other chemotherapy utilized includes paclitaxel and interferon. 16 pts (12.3%) died, of which only two died of disseminated AIDS-KS.

Conclusions

Our retrospective study confirms that ¾ of pts diagnosed with KS have AIDS-KS. Despite introduction of HAART and the well-controlled nature HIV/AIDS, KS continues to develop. AIDS-KS pts are younger, more likely to have metastatic disease and more frequently require chemotherapy. Poorly controlled HIV still portends a worse outcome in AIDS-KS. Further investigations are required to better understand the etiology of AIDS-KS in pts with undetectable HIV viral loads.

Clinical trial identification

Legal entity responsible for the study

Northwestern University.

Funding

Lurie Cancer Center.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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