AIDS malignancies represent an increasing cause of morbidity and mortality for persons with HIV infection. For example, in both the ACTG 019 trial and in the Concorde trial, malignancies accounted for over 25% of the study endpoints in these asymptomatic, HIV infected populations. In the ACTG 196 trial, a trial in very advanced patients, malignancies accounted for over 23% of the deaths. Clearly, as patients with HIV infection live longer, malignant complications will become more frequent and more devastating. Fortunately, there has been substantial progress in our understanding of the pathogenesis of several AIDS related malignancies. The improved basic science understanding has provided many new leads for drug development. It is hypothesized that a systematic evaluation of the multiple new therapeutic opportunities will result in a significant increase in the life expectancy for patients with HIV infection. UCLA has been at the fore front in the battle against AIDS and its malignant complications. UCLA was one of the first to have a malignancy clinic and continues to have one of the largest Kaposi sarcoma clinics in the world. Basic scientists at UCLA have contributed significantly to our understanding of this disease and AIDS related lymphomas. Clinicians at UCLA have designed, enrolled and completed many important trials in AIDS related malignancies. Investigators at UCLA have a particular expertise in the use of cytokines and immune modulators. This application proposes to utilize the combined talents of two investigators with an extensive experience in the treatment of AIDS malignancies. It will take advantage of our experience in cooperative group trials such as the AIDS Clinical Trials Group. It will also use the AIDS Malignancy Bank that is located at UCLA. The contribution of UCLA to the overall effort of the AIDS Malignancy Clinical Trials Consortium will advance our understanding and the treatment of these diseases.
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