Aboobaker, J

Coovadia, HM

Friedland, G

Jordaan, JP

Mosam, A

Shaik, F

Skadden, D

Uldrick, TS

Infectious Agents and Cancer

Harvard University - DASH

 Prognosis of patients with AIDS-associated Kaposi's sarcomareceiving antiretroviral therapy +/- chemotherapy in Kwazulu-Natal,South Africa: an analysis of 1-yr survival data from NCT00380770  (Article begins on next page)The Harvard community has made this article openly available.Please share how this access benefits you. Your story matters.Citation Uldrick, TS, A Mosam, F Shaik, G Friedland, D Skadden, JPJordaan, J Aboobaker, and HM Coovadia. 2009. “Prognosis ofpatients with AIDS-associated Kaposi's sarcoma receivingantiretroviral therapy +/- chemotherapy in Kwazulu-Natal, SouthAfrica: an analysis of 1-yr survival data from NCT00380770.”Infectious Agents and Cancer 4 (Suppl 2): P41. doi:10.1186/1750-9378-4-S2-P41. http://dx.doi.org/10.1186/1750-9378-4-S2-P41.Published Version doi:10.1186/1750-9378-4-S2-P41Accessed February 17, 2015 8:33:40 AM ESTCitable Link http://nrs.harvard.edu/urn-3:HUL.InstRepos:13581179Terms of Use This article was downloaded from Harvard University's DASHrepository, and is made available under the terms and conditionsapplicable to Other Posted Material, as set forth athttp://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAABioMed  CentralPage 1 of 2(page number not for citation purposes)Infectious Agents and CancerOpen Access Poster presentationPrognosis of patients with AIDS-associated Kaposi's sarcoma receiving antiretroviral therapy +/- chemotherapy in Kwazulu-Natal, South Africa: an analysis of 1-yr survival data from NCT00380770TS Uldrick*1,2, A Mosam3,4, F Shaik2,4, G Friedland7, D Skadden8, JP Jordaan5, J Aboobaker4 and HM Coovadia6Address: 1Mailman School of Public Health, Columbia University, New York. New York, USA, 2Columbia University – South Africa Fogarty AIDS International Training and Research Program, New York, New York, USA, 3PI NCT00380770, 4Department of Dermatology, Doris Duke Medical Research Institute; Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, South Africa, 5Department of Oncology, Doris Duke Medical Research Institute; Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, South Africa, 6Victor Daitz Chair of HIV Research, Doris Duke Medical Research Institute; Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, South Africa, 7Yale University, New Have, Connecticut, USA and 8Harvard Medical School, Boston, Massachusetts, USA* Corresponding author    ObjectiveAIDS-associated Kaposi's Sarcoma (KS) is an increasingpublic health problem in KwaZulu-Natal, South Africa.The optimal management of AIDS-associated KS in sub-Saharan Africa is unknown. NCT00380770 is a singlecenter randomized clinical trial of 112 patients withAIDS-associated KS who received a nivirapine based anti-viral regimen (ARV) alone, or with chemotherapy (doxo-rubicin, bleomycin and vincristine) between 2003 and2007. We evaluated 1-year overall survival (OS) and theACTG staging system in our study population.DesignCohort study.MethodsBaseline TIS staging information is available for allpatients. One-year survival data is available for 105 studysubjects, with only seven subjects lost to follow-up. OSwas evaluated using Kaplan-Meier hazard function meth-odology. Survival functions were generated for subjectswith 0, 1, 2 and 3 adverse prognostic variables using themodified ACTG TIS staging system (CD4 cut-off = 150).Univariate and multivariate Cox proportional hazardregression was performed to evaluate the prognostic valueof individual and combined variables on OS in the studyfrom 11th International Conference on Malignancies in AIDS and Other Acquired Immunodeficiencies (ICMAOI): Basic, Epidemiologic, and Clinical ResearchBethesda, MD, USA. 6–7 October 2008Published: 17 June 2009Infectious Agents and Cancer 2009, 4(Suppl 2):P41 doi:10.1186/1750-9378-4-S2-P41<supplement> <title> <p>Proceedings of the 11th International Conference on Malignancies in AIDS and Other Acquired Immunodeficiencies (ICMAOI): Basic, Epidemiologic, and Clinical Research</p> </title> <sponsor> <note>Publication of this supplement was made possible with support from the Office of HIV and AIDS Malignancy, National Cancer Institute, National Institutes of Health.</note> </sponsor> <note>Meeting abstracts – A single PDF containing all abstracts in this Supplement is available <a href="http://www.biomedcentral.com/content/files/pdf/1750-9378-4-S2-full.pdf">here</a>.</note>  <url>http://www.biomedcentral.com/content/pdf/1750-9378-4-S2-info.pdf</url> </supplement>This abstract is available from: http://www.infectagentscancer.com/content/4/S2/P41© 2009 Uldrick et al; licensee BioMed Central Ltd. Table 1: Baseline demographicsRandomization ARV 53%Combination 47%Sex F 55% M = 45%Age Range 18–62Region Urban 70% Rural 30%T 0 = 14% 1 = 86%I 0 = 45% 1 = 55%S 0 = 56% 1 = 44%Publish with BioMed Central    and   every scientist can read your work free of charge"BioMed Central will be the most significant development for disseminating the results of biomedical research in our lifetime."Sir Paul Nurse, Cancer Research UKYour research papers will be:available free of charge to the entire biomedical communitypeer reviewed and published  immediately upon acceptancecited in PubMed and archived on PubMed Central yours — you keep the copyrightSubmit your manuscript here:http://www.biomedcentral.com/info/publishing_adv.aspBioMedcentralInfectious Agents and Cancer 2009, 4(Suppl 2):P41 http://www.infectagentscancer.com/content/4/S2/P41Page 2 of 2(page number not for citation purposes)cohort. Survival analysis was performed with Stata 10 forMacintosh.ResultsBaseline characteristics are listed in Table 1. One-year OSin the overall cohort was 76.6 percent. For subjects with 0,1, 2 and 3 adverse prognostic risk factors, the one-year OSwas 100 percent, 89 percent, 73 percent and 61 percent(Figure 1). Results from univariate and multivariate Coxproportional hazard regression analyses are listed in Table2. For the Cox proportional hazards regression modelincluding T, I, and S, the LR χ2 (3) = 8.45, with p = 0.0375.ConclusionIn NCT00380770, 1-year OS in a cohort of AIDS-associ-ated KS subjects in a resource limited setting is dramati-cally improved compared to historical sub-Saharancohorts prior to the availability of ARVs. The ACTG Stag-ing system is clinically useful in resource-limited settings.It is notable that for 86 percent T = 1 disease and universalARV use HIV-associated systemic illnesses, whichincluded 15 subjects with tuberculosis, is the most signif-icant prognostic factor. Analysis of response rates, overallsurvival, adverse events, and quality-of-life between thetwo arms in NCT00380770 is ongoing.Table 2: Cox Proportional Hazard RegressionPrognostic variable Univariate MultivariateT HR = 2 p = 0.34 HR = 1.8 p = 0.44I HR = 2 p = 0.11 HR = 1.8 p = 0.16S HR = 2.7 p = 0.02 HR = 2.4 p = 0.04HR = Hazard ratio of death for score of 1 compared to score of 0Overall survival Figure 1Overall survival.

Prognosis of patients with AIDS-associated Kaposi's sarcoma receiving antiretroviral therapy +/- chemotherapy in Kwazulu-Natal, South Africa: an analysis of 1-yr survival data from NCT00380770

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Prognosis of patients with AIDS-associated Kaposi's sarcoma receiving antiretroviral therapy +/- chemotherapy in Kwazulu-Natal, South Africa: an analysis of 1-yr survival data from NCT00380770

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