EP047/#629 Response to treatment and overall survival of cervical cancer in women with and without HIV in Botswana: ipabalele study U54 CA190158-01

Objectives

This study aimed to characterize factors associated with survival and response to treatment among women with cervical cancer in Botswana.

Methods

Patients with histologically confirmed cervical cancer were prospectively enrolled between Jan 2015 and June 2019 to the Ipabalele study in Botswana. Response to treatment was characterized using squamous cell antigen (SCCAg) level <2.2ng/ml at the end of treatment and 3 months post treatment.

Results

Of 293 women diagnosed with cervical cancer, 73.7% (n=216) were women living with HIV (WLWH). Fifty-six percent (n=150) of all patients had a complete response to treatment by clinical assessment and 65% (n=78) based on SCC-Ag. There was no difference in response to treatment by either clinical or SCC-Ag by HIV status. Two-year overall survival (OS) probability was 73%. There was no difference in survival by HIV status (5-year OS was 57.1% for WLWH and 61.9% for those without). Survival probability difference by HIV status was not significant. In multivariate regression, EQD2 >80Gy (p<0.0001) and at least four chemotherapy cycles (p=0.002), were significantly related to OS. In logistic regression of clinical and SCC-Ag response, only final stage was associated with clinical response (p<0.001). Among patients with clinical and SCC-Ag documented (n=118), there was no correlation between SCC-Ag and clinical response.

Conclusions

Multivariate survival regression of cervical cancer patients demonstrated EQD2 >80Gy and greater than 4 cycles of chemotherapy were associated with OS. There was no difference in OS by HIV status. Further studies are needed to evaluate cut-offs for SCC-Ag and the role of SCC-Ag in Sub-Saharan Africa.