Chemo for Cancer Patients With HIV May Change
Doctors may need to use more or less chemotherapy for cancer patients who are also HIV-positive, according to the Georgetown oncologist leading the first nationwide study to test new chemotherapy drugs in such patients.
“Given the type of drug cocktail patients use for HIV, much more or considerably less chemotherapy may be warranted,” explains Deeken, a faculty member at Georgetown’s Lombardi Comprehensive Cancer Center.
Deeken is working with researchers at the NCI-supported AIDS Malignancy Consortium. The research team presented the design for the study’s clinical trials at the 2010 meeting of the American Society of Clinical Oncology this past June.
“Cancer unrelated to AIDS is rapidly increasing in HIV-positive patients,” says Deeken, “yet many oncologists do not know how to treat these cancers, and these patients are also excluded from cancer clinical trials.”
He says such patients also experience more aggressive cancers that occur at younger ages with higher rates of relapse and less favorable outcomes.
No Other Studies
While some have expressed concern about whether cancer treatments might be contraindicated with HIV/AIDS medications, the professor says there is no evidence of that to date.
“There haven’t been any studies looking at this and consequently, there are no standard approaches or guidelines to treat non-AIDS related cancers in these patients,” notes Deeken, a 2001 graduate of the Georgetown School of Medicine.
The research team is examining whether a family of metabolizing enzymes in the liver causes cancer drugs in patients using HIV medications to become toxic or too weak.
Treatments that Work
While they specifically tested a new chemotherapy called Sutent, the study applies to about half of all cancer drugs that use the same enzymes.
Patients treated with one type of drug cocktail to treat HIV may need more cancer chemotherapy, while patients being treated with another type appear to need less chemotherapy, according to preliminary study findings.
Deeken says that’s because these HIV treatments block the activity of liver enzymes, so that “normal” levels of Sutent and similar chemotherapies may be too potent and cause unwanted side effects.
Hope for the Future
He hopes additional findings will suggest the best doses for a wider variety of cancer therapies.
“This is what science does,” Deeken says. “It asks and answers questions that matter to people.”
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