A Snapshot of Kaposi Sarcoma

Incidence

Kaposi sarcoma (KS) is a soft-tissue sarcoma that affects the skin, oral cavity, esophagus, and anal canal. "Classic" KS is rare and found mainly in older men of Mediterranean or Jewish ancestry. Immunosuppressed individuals are also at increased risk for KS. The incidence of KS rose sharply in the 1980s with the emergence of the acquired immune deficiency syndrome (AIDS), and it is now the most common tumor associated with human immunodeficiency virus (HIV) infection. In the United States, infection with HIV is by far the greatest risk factor for KS.

The incidence of KS began to drop dramatically in the mid-1990s with the introduction of highly active antiretroviral therapy (HAART), which partially restores immune system function, and has remained relatively stable since 2000. Men are much more likely to develop KS than women, particularly between the ages of 25 and 59. Since the mid-1990s, the incidence rate has been highest in African Americans.

Scientists have identified a virus called Kaposi sarcoma-associated herpesvirus (KSHV) or human herpesvirus 8 (HHV8) as the cause of KS. Standard treatments for KS include radiation therapy, surgery, chemotherapy, and biological therapy.

Trends in NCI Funding for Kaposi Sarcoma Research

The National Cancer Institute's (NCI) investment¹ in KS research increased from $24.1 million in fiscal year (FY) 2007 to $27 million in FY 2008, before decreasing to $24.5 million in FY 2011. In addition to this funding, NCI supported $11 million in KS research in FY 2009 and 2010 using funding from the American Recovery and Reinvestment Act (ARRA)².

Examples of NCI Activities Relevant to Kaposi Sarcoma

• The Kaposi Sarcoma Working Group, part of the AIDS Malignancy Consortium, supports studies on new treatment options for patients with KS and develops comprehensive procedures for evaluating KS response data and correlating these data with patient outcomes.
• The Office of HIV and AIDS Malignancy coordinates and prioritizes HIV/AIDS-related research throughout NCI and oversees several research programs in HIV/AIDS and HIV-associated cancers.
• NCI's Infections and Immunoepidemiology Branch conducts epidemiologic research on infectious agents and cancer, including KS and other HIV/AIDS-associated malignancies. Projects include assessing the effects of smoking, of other environmental exposures, and of immunity- and inflammation-related genes on the risk of KSHV infection and exploring the genomic integrity of KS.
• The Cancer Etiology Branch (CEB) supports research programs dealing with biological, chemical, and physical agents that are known or possible carcinogens. The research program in HIV- and AIDS-associated malignancies supports investigations of the role of HIV and other viruses as etiologic agents of AIDS-associated cancers and how their interactions affect carcinogenesis and cancer progression.
• The Center of Excellence in HIV/AIDS and Cancer Virology facilitates and communicates advances in antiviral and immunologic approaches for preventing and treating HIV infection, AIDS-related malignancies, and cancer-associated viral diseases.
• The Biomarkers of Infection-Associated Cancers is a funding opportunity that encourages researchers to submit project proposals to identify biomarkers for cancers whose etiology is attributed to infectious agents, including HIV.

Selected Advances in Kaposi Sarcoma Research

• Researchers determined that during 1980-2007 about 82 percent of KS cases in the United States occurred among people with AIDS and that the proportions of AIDS-defining cancers that occurred in people with AIDS peaked in the mid-1990s and then declined with the introduction of HAART. Published April 2011. [PubMed Abstract]
• Researchers studying oral KS, which may be more resistant to chemotherapy than other forms of KS and has poorer prognosis, identified two potential pathways involved in KS pathogenesis that could provide new targets for therapy. Published December 2011. [PubMed Abstract]
• A new experimental system may help scientists understand how KSHV infection transforms healthy cells into cancerous cells. Published February 2012. [PubMed Abstract]
• Results of a small clinical trial indicate that the targeted cancer drug bevacizumab is tolerated and active in some patients with HIV-associated KS receiving HAART. Published March 2012. [PubMed Abstract]
• See this PubMed list of selected free full-text journal articles on NCI-supported research relevant to Kaposi sarcoma. You can also search PubMed for additional scientific articles.

• ¹ The estimated NCI investment is based on funding associated with a broad range of peer-reviewed scientific activities. For additional information on research planning and budgeting at the National Institutes of Health (NIH), see About NIH.
• ² For more information regarding ARRA funding at NCI, see Recovery Act Funding at NCI.
• ³ Scientific Area Codes
• ⁴ NCI Funded Research Portfolio