Cancer in People Living With HIV, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology

Reid, Erin; Suneja, Gita; Ambinder, Richard F.; Ard, Kevin L.; Baiocchi, Robert A.; Barta, Stefan K.; Carchman, Evie H.; Cohen, Adam L.; Gupta, Neel K.; Johung, Kimberly L.; Klopp, Ann H.; LaCasce, Ann S.; Lin, Chi; Makarova-Rusher, Oxana V.; Mehta, Amitkumar; Menon, Manoj; Morgan, David S.; Nathwani, Nitya; Noy, Ariela; Palella, Frank J.; Ratner, Lee; Rizza, Stacey A.; Rudek, Michelle A.; Taylor, Jeff; Tomlinson, Benjamin; Wang, Chia Ching J.; Dwyer, Mary A.; Freedman-Cass, Deborah A.

doi:10.6004/jnccn.2018.0066

Cited by 81 publications

(63 citation statements)

References 78 publications

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“…HIV‐infected people are generally excluded from clinical trials; therefore, data on toxicity, outcomes and possible drug interactions during cancer treatment are limited. Despite the increased toxicity and drug–drug interactions, HAART withdrawal during chemotherapy is unfavorable in HIV‐patients with cancer and can lead to a poorer outcome; therefore, in general, any HAART interruption is not advisable during cancer treatment . Possible drug–drug interactions should be therefore carefully assessed when treating cancer in HIV‐infected patients.…”

Section: Hiv and Cancer Treatment In The Haart Eramentioning

confidence: 99%

“…Drug–drug interactions rely on many factors, such as the route of elimination, the effect on enzymes and transporters involved in drug metabolism. Both HAART and antioneoplastic drugs can be metabolized by CYP450 enzyme family and serve as CYP450 inhibitors, which can lead to drug accumulation and potential toxicity, or as CYP450 inducers, which leads to drug elimination and decreased efficacy, except for active metabolites of several drugs . As an example, ritonavir*, a PI and a potent CYP3A4 inhibitor, was reported to be associated with more severe toxicity in combination with chemotherapy compared to nonritonavir‐based HAART .…”

Section: Hiv and Cancer Treatment In The Haart Eramentioning

confidence: 99%

“…On the contrary, NNRTIs are mainly CYP3A inducers . HAART regimen should be modified when facing undesirable drug–drug interactions or elevated toxicity . In this case, preference can be given to the INSTI‐based regimen, which is supposed to be relatively safe .…”

Section: Hiv and Cancer Treatment In The Haart Eramentioning

confidence: 99%

“…HAART regimen should be modified when facing undesirable drug–drug interactions or elevated toxicity . In this case, preference can be given to the INSTI‐based regimen, which is supposed to be relatively safe . Both NNRTIs and INSTIs are superior to PIs in terms of viral suppression in HIV‐infected patients with malignancies .…”

Section: Hiv and Cancer Treatment In The Haart Eramentioning

confidence: 99%

“…Both NNRTIs and INSTIs are superior to PIs in terms of viral suppression in HIV‐infected patients with malignancies . Regarding the complexity of multidrug interaction, if a patient is HAART‐naive, it is recommended to start HAART more than a week before or after the cancer treatment in order to differentiate between adverse effects . It is also recommended that clinicians consult major reviews dedicated to the topic of potential drug–drug interactions between HAART and chemotherapeutic drugs, treatment guidelines and refer to available resources such as http://www.hiv-druginteractions.org to optimize clinical management of HIV‐infected patients with cancer and increase therapeutic benefit.…”

Section: Hiv and Cancer Treatment In The Haart Eramentioning

confidence: 99%

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HIV‐1, HAART and cancer: A complex relationship

Шмакова

Germini

Vassetzky

2019

Intl Journal of Cancer

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HIV infected people are at higher risk of developing cancer, although it is globally diminished in the era of highly active antiretroviral treatment (HAART). Recently, antioncogenic properties of some HAART drugs were discovered. We discuss the role of HAART in the prevention and improvement of treatment outcomes of cancers in HIV‐infected people. We describe different trends in HAART–cancer relationships: cancer‐predisposing as well as cancer‐preventing. We cover the roles of particular drug regimens in cancer prevention. We also describe the causes of cancer treatment with HAART drugs in HIV‐negative people, including ongoing clinical studies that may directly point to a possible independent anti‐oncogenic activity of HAART drugs. We conclude that despite potent antioncogenic activities of every class of HAART drugs reported in preclinical models, the evidence to date indicates that their independent clinical impact in HIV‐infected people is limited. Improved cancer prevention strategies besides HAART are needed to reduce HIV‐cancer‐related mortality.

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Section: Hiv and Cancer Treatment In The Haart Eramentioning

confidence: 99%

Section: Hiv and Cancer Treatment In The Haart Eramentioning

confidence: 99%

Section: Hiv and Cancer Treatment In The Haart Eramentioning

confidence: 99%

Section: Hiv and Cancer Treatment In The Haart Eramentioning

confidence: 99%

Section: Hiv and Cancer Treatment In The Haart Eramentioning

confidence: 99%

See 3 more Smart Citations

HIV‐1, HAART and cancer: A complex relationship

Шмакова

Germini

Vassetzky

2019

Intl Journal of Cancer

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Neoplasms in People Living with Human Immunodeficiency Virus

Wang¹,

Chiao²

2022

Holland‐Frei Cancer Medicine

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People living with human immunodeficiency viruses (PLWH) are at increased risk for developing malignancies, particularly virally mediated cancers such as Kaposi sarcoma (KS), some types of lymphoma, and HPV‐related cancers, such as cervical cancer and anal cancer. PLWH also have higher rates of alcohol and tobacco use, which increases their risk of non‐virally mediated cancers, such as lung cancer and both oropharyngeal and non‐oropharyngeal head and neck cancers. KS and lymphomas tend to occur at lower CD4 counts, and the incidences of these cancers have decreased since the advent of effective combination antiretroviral therapy (ART). However, the incidence for virally mediated cancers (such as anal cancer) other non‐virally‐mediated non‐acquired immunodeficiency syndrome‐defining cancers (such as lung cancer) have risen in the past decade in part because PLWH are living longer with wide‐spread access to ART. In the past, PLWH with cancers often had lower survival and poorer outcomes due to severe immunodeficiency and poor performance status. In the modern ART era, survival and outcomes for individuals with human immunodeficiency virus (HIV)‐associated lymphomas are generally similar to the HIV‐negative population using standard rituximab‐based multi‐agent chemotherapy. For PLWH with other solid tumors, standard of care treatment is also currently recommended. Active areas of research for cancers in PLWH includes cancer prevention, immunotherapy, and continued development of new therapeutics to improve outcomes.

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Impact of HIV status on prognosis of malignancies among people living with HIV in Japan

Ando,

Shimomura,

Watanabe

et al. 2024

Cancer

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BackgroundAntiretroviral therapy has reduced the incidence and mortality of AIDS‐defining malignancies (ADM); however, non–AIDS‐defining malignancies (NADM) are a major cause of death among people living with HIV (PLWH) today. Though current guidelines suggest that PLWH should receive the same treatment as the general population, there are limited studies focused on how HIV status affects the prognosis of cancers. The present study aimed to investigate the characteristics and prognosis of malignant diseases among PLWH in Japan.MethodsPatients with HIV diagnosed with malignant diseases at our institution between 2011 and 2021 were retrospectively reviewed.ResultsThere were 205 patients who were diagnosed with malignancies. Of these, 87 (42.4%) were diagnosed with ADM and 118 (57.6%) were diagnosed with NADM. Among 69 patients who received chemotherapy for ADM, 24 (34.8%) developed AIDS‐defining opportunistic infections during treatment. In contrast, only one (1.8%) of the 56 patients administered chemotherapy for NADM developed AIDS‐defining opportunistic infections. Complications of opportunistic infections at diagnosis of malignancies, low CD4+ T‐cell count, positive HIV RNA, and nonadministration of antiretroviral therapy were associated with 5‐year overall survival among patients with malignant lymphomas. However, the variables associated with HIV did not affect NADM prognosis.ConclusionsIn this analysis, HIV status had a small impact on the prognosis of malignant diseases in PLWH. Few patients with NADM developed AIDS‐defining opportunistic infections after receiving chemotherapy.

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Cancer in People Living With HIV, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology

Cited by 81 publications

References 78 publications

HIV‐1, HAART and cancer: A complex relationship

HIV‐1, HAART and cancer: A complex relationship

Neoplasms in People Living with Human Immunodeficiency Virus

Impact of HIV status on prognosis of malignancies among people living with HIV in Japan

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