e14590 Background: In the non-HIV population, radiotherapy (RT), fluorouracil (5FU) with mitomycin (MMC) has become the standard in the non-metastatic setting for anal carcinomas (AC). To date, most studies with AC in HIV patients (pts) are small case series where multiple chemoradiation (CRT) regimens were used and analyzed as one cohort. In addition, little data exists on the inner city HIV population. Cook County Hospital (CCH) is the largest health provider for HIV pts in Chicago and together with its outpatient clinic, the Ruth M. Rothstein CORE Center (CC) 5,500 HIV+ pts are treated per year. The County Hospital (CCH) AIDS Malignancy Project (CHAMP Study) is a retrospective study of all HIV cancer pts treated for the past 14 years. Methods: We identified all HIV+ pts with invasive AC in CHAMP cohort. We analyzed HIV characteristics, overall survival (OS), PFS and pt demographics and compared it to a HIV- cohort from the same institution. All AC treated without MMC/5FU/RT were excluded. Statistics: Time to local recurrence (TLR), time to distant metastasis (TDM), and OS data was analyzed using Kaplan-Meier analysis and a Cox Proportional Hazards model. Results: 35 HIV + and 52 HIV - pts were included. Of the HIV+ vs. HIV- pts, 89 vs. 52% were male, 82 vs. 48% were AA and the average age in HIV+ vs. HIV- was 44 vs. 52 yrs. 45 % of the HIV pts presented with stage IIIA or IIIB disease vs. 46% in HIV- pts. 15 % HIV- pts had stage IV vs. 0% HIV +. The median survival in the HIV+ vs. HIV- was 34 vs. 39 mo (p>0.5). In the HIV- population, 22% survived 120 months, while no HIV pt survived over 90 months. TLR was 20 months shorter in the HIV+ arm (p<0.5). OS based on CD4 count did not differ. Conclusions: HIV associated AC is an AA male disease compared to HIV- pts in the inner city. More stage IV disease was reported in the HIV- cohort, but the median survival was equal with no long-term survivors in the HIV+ arm, possibly due to TLR, which was 20 months shorter, implying more aggressive disease. Both inner city groups present late but tolerate chemotherapy equally well. Education is needed in both HIV+ and HIV- pts to diagnose the cancers early so the OS can match the national average.
e12523 Background: From 1991 to 2005, the number of cases of non-AIDS defining cancers (NADC) rose from 3,192 to 10,059 in the USA. Studies have shown an improvement in survival for many HIV-associated malignancies in the post HAART era. Drug-drug interactions between HIV therapy and chemotherapy (CTX) are not well understood. HIV medications can inhibit or induce the cytochrome p450 system, modulating CTX clearance. To understand CTX-HIV medication interactions, we performed a retrospective analysis of all patients (pts) diagnosed with a solid NADC who took CTX with combined antiretroviral therapy (cART). Methods: 157 pts with solid NADC were identified via a computer search at County Hospital. Adverse events (AE) during CTX in pts taking cART were assessed by chart review and graded per the NCI Common Terminology Criteria. Statistics: A Fisher's exact test was used to examine the differences in AE incidence. Results: Patients who did not take cART in conjunction with, or did not require CTX, were excluded. The number of pts analyzed for anal cancer (n=25), lung carcinoma (n=9), breast (n=7), and head and neck carcinoma (HNSCC) (n=4) represents 94% of pts taking cART with CTX in our cohort. Interestingly, Forty-two pts (50%) never received cART during therapy. All pts with anal carcinoma were treated with mitomycin/5FU/radiotherapy. 46 % of the patients taking ritonavir-based cART (6 pts of 13) developed a G4 neutropenia versus 8% (1 pt of 12) taking non-ritonavir cART (p<0.07). Anemia all grades with ritonavir, 54%, versus non-ritonavir cART 16% (p<0.09). All grades neutropenia for lung carcinoma while taking ritonavir was 83% versus 33% while taking non-ritonavir cART. No other correlations were identified. In this cohort, 17 pts received platinum (37%), taxanes (n=5) (11%), anthracyclines (n=5) 11%, gemcitabine (n=2) (4%), and pemetrexed (n=1). No difference in AE was noted between any CTX class, AE, and cART. Conclusions: Ritonavirinduced a 38% increase in G4 neutropenia and anemia during treatment of anal carcinoma with mitomycin/5FU. More trials including HIV-associated cancer pts are needed to assess the role of cART when given in conjunction with CTX.
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