When To Treat Kaposi'S Sarcoma? Paclitaxel Survival Benefit On Classic Versus Aids/Hiv-Related Subtypes.

11077 Background: Kaposi’s Sarcoma (KS) is a angioproliferative disease related to AIDS/HIV (AIDS-KS) or not (Classic, CKS). Treatment options are limited in low-income countries where taxanes represent a cost-effective alternative. Our aim was to compare overall response (ORR) of paclitaxel and progression free survival (PFS) and overall survival (OS) between KS subtypes. Methods: We reviewed 203 medical records from pts diagnosed between 2002-2014 at the Instituto Nacional de Enfermedades Neoplasicas (Peru). Survival differences were calculated by log-rank test in the univariate analysis and Cox regression analysis for prognostic factors. Results: From 203 pts, 85 had CKS and 118 AIDS-CK. Mean age was 67 and 36years in CKS and AIDS-KS, respectively. Most pts were males (84.7%), coinfections as tuberculosis (11.9%) were more frequent in AIDS-CK. In CKS pts, 80% debuted with localized elevated lesions at lower limbs, 16% were resected, 48% received RT and 29% paclitaxel. Among AIDS-KS, 37% had poor risk, 22% were diagnosed concurrently to HIV infection. 76.9% had generalized lesions with origin at lower limbs, 50.5% had +ve nodes and 19% visceral disease. 25.8% had Zubrod > 2 and mean neutrophil to lymphocyte ratio (NLR) was 3.5, CD4 count was lower in pts with recently diagnosis of AIDS/HIV (166 vs 268, p = 0.039) and no differences were noted on viral load (mean 233 411). 77.1% of AIDS-KS pts received ART and 56.8% paclitaxel. In AIDS-KS ORR was 77%(CR:52%, PR:22%) versus 86% in CKS (CR:43%, PR:43%). At 4.3year median follow-up, 3-year PFS and OS was 71% and 75% in AIDS-CK, while CKS had 78% and 79%, respectively. Paclitaxel was associated with better survival among AIDS-KS patients (PFS HR:0.41, 95%CI:0.2-0.7, p = 0.004 and OS HR: 0.37, 95%CI:0.1-0.7, p = 0.007), patients with Zubrod≤2 had more survival benefit. There was not survival benefit in CKS pts. At multivariate analysis, ART and paclitaxel were associated with favorable PFS and OS, while higher NLR and poorer status performance to worse outcomes in AIDS-KS pts. Conclusions: Paclitaxel is an effective alternative treatment for AIDS-KS, there was not survival benefit in CKS patients. Poorer status performance and higher NLR were associated to worse prognosis.