Lung Cancer (LC) in HIV Positive Patients: Pathogenic Features and Implications for Treatment
Abstract
:1. HIV and Cancer Risk
2. Lung Cancer Features in HIV Infected Patients
3. Therapy
3.1. Surgery and Radiotherapy
3.2. Chemotherapy and Target Therapy
3.3. Immunotherapy
4. Perspectives
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Lung Cancer Features | Subgroups | HIV + Patients | General Population | References |
---|---|---|---|---|
Standardized incidence ratio (SIR) | - | 2.6 (2.1–3.1) | - | Shiels MS et al. J Acquir Immune Defic Syndr 2009 |
Median age at cancer diagnosis | - | 44–52 years | 70 years | Shiels MS, et al. Ann Intern Med 2010 |
Gender | male | 86% | 57.8% | Spano JP et al. Med Oncol 2004 |
Race | white | no current available data | ||
black | ||||
Stage at diagnosis | stage III or IV | 77–100% | 75% | Kiderlen TR et al. Oncol Res Treat 2017 |
Histological type | adenocarcinoma | 49% | 36–50% | Kiderlen TR et al. Oncol Res Treat 2017 |
squamous cell carcinoma | 20% | 27–30% | ||
large cell carcinoma | 3% | 4–18% | ||
small cell carcinoma | 15% | 3–9% | ||
Survival rate | 2-year | 10% | 31% | Biggar RJ et al. J Acquir Immune Defic Syndr 2005 |
5-year | 10% | 19% | Marcus JL et al. Cancer Epidemiol Biomarkers Prev 2015 |
Trial NCT (Acronimus) | Drug Tested | Trial Title | Endpoint and Results** | Status |
---|---|---|---|---|
01296113 (CHIVA) | Carboplatin plus pemetrexed | Chemotherapy for LC in HIV+ pts with advanced non-squamous NSCLC | DCR after 4 cycles of carboplatin plus pemetrexed | Completed No results posted |
00276588 | Gemcitabine plus carboplatin followed by paclitaxel | Gemcitabine and carboplatin followed by paclitaxel in pts with PS = 2,3 or other significant co-morbidity (HIV or s/p organ transplantation) in advanced NSCLC | Sequential ChT is well tolerated and active. The survival is comparable to that of other regimens utilized in PS = 2 pts with superior tolerability. The prognosis for these pts is very poor even with treatment | Completed Results posted |
02134886 | Erlotinib | Erlotinib Hydrochloride in treating NSCLC that is metastatic or cannot be removed by surgery in pts with HIV | Safety, tolerability and MTD of erlotinib in combination with ART | Terminated (Poor enrolment) |
01822522 | Cabozantinib | Cabozantinib S-Malate in treating pts with advanced solid tumors and HIV | Safety, tolerability and MTD of cabozantinib | Recruiting |
03304093 (CHIVA2) | Nivolumab | Immunotherapy by nivolumab for HIV+ pts with advanced NSCLC | DCR | Recruiting |
03767465 (PembroHIV) | ICI | Treatment with ICIs of HIV-infected subjects with cancer (advanced melanoma or other cancers in which the use of ICIs is clinically indicated) | Changes in HIV-viral load and immune-phenotype of cellular populations | Completed No results posted |
02408861 | Ipilimumab plus nivolumab | Nivolumab and ipilimumab in treating pts with HIV associated relapsed or refractory classical HL or solid tumors (comprising LC) that are metastatic or cannot be removed by surgery | MTD of nivolumab, ORR, immune function, change in immune status/HIV viral load | Recruiting |
00791336 | Nelfinavir with RT and ChT | Study to evaluate using nelfinavir with chemoradiation for NSCLC | PCR | Terminated (Poor enrolment) |
01249443 | Paclitaxel plus carboplatin | Paclitaxel and carboplatin in treating pts with metastatic or recurrent solid tumors (comprising NSCLC) and HIV | - Safety, tolerability of vorinostat in combination with ChT. - MTD of the combination | Terminated (Inadequate accrual rate) No results posted |
01567722 | - | Collecting and studying tissue samples from pts with HIV-Associated Malignancies (diffuse large B-cell lymphomas, LC, anal cancer and cervical cancer) | - To obtain high-quality tissue from pts with HIV-1 malignancy - To study clinical, genetic, and immunologic parameters with prognostic significance and/or involved in the initiation/progression of HIV-1 malignancies, including complete NGS of HIV-associated cancers | Recruiting |
01748136 (NA_00036809) | - | Screening for LC in the HIV pts | Differences in stage distribution of HIV-seropositive pts at LC diagnosis between those who are screened by spiral CT and historic controls | Completed No results posted |
01207986 (EP48 HIV CHEST) | - | Early LC diagnosis in HIV infected population with an important smoking history with low dose CT: a pilot study | Prevalence of LC detected by low-dose CT scan | Completed No results posted |
00491335 | - | HIV infection and tobacco use among injection drug users in Baltimore, Maryland: a pilot study of biomarkers | - To characterize smoking habits and compare tobacco use among HIV-infected and uninfected drug users - To compare serum nicotine levels and spirometry results, as a marker of tobacco use and a marker of damage to lung function, respectively | Completed No results posted |
01447589 (NelfLung) | Nelfinavir plus radical radiotherapy | Radical lung radiotherapy plus nelfinavir | MTD of nelfinavir | Withdrawn (poor enrolment ) |
00589056 | Nelfinavir with RT and ChT | Nelfinavir, RT, cisplatin and etoposide in treating (HIV-uninfected) pts with stage III NSCLC that cannot be removed by surgery | Nelfinavir administered with concurrent ChT-RT is associated with acceptable toxic effects and a promising ORR, local failure, PFS and OS in unresectable NSCLC | Completed |
03367754 | Pembrolizumab | A single dose of pembrolizumab in HIV-infected people | Safety of pembrolizumab in PLWH who have a low CD4+ T cell count despite taking medicines that control HIV replication | Recruiting |
02595866 | Pembrolizumab | Pembrolizumab in pts with HIV and relapsed/refractory or disseminated malignant neoplasm (comprising NSCLC) | - Frequency of observed AEs - Incidence of immune-related AEs of clinical interest - Incidence of cART-related AEs | Recruiting |
03858491 (POP-NSCLC) | Osimertinib | Pharmacokinetic Boosting of Osimertinib in pts with EGFR-mutated NSCLC | Evaluate if systemic exposure of osimertinib is increased when it is co-administered with anti-HIV drug cobicistat | Not yet recruiting |
03706625 (IDeATIon) | - | Integrated discovery of new immuno-molecular actionable biomarkers for tumors with immune-suppressed environment | Analyse tumor biomarkers on frozen biopsy for three types of cancer (non-HL, LC and glioma) | Not yet recruiting |
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Frega, S.; Ferro, A.; Bonanno, L.; Guarneri, V.; Conte, P.; Pasello, G. Lung Cancer (LC) in HIV Positive Patients: Pathogenic Features and Implications for Treatment. Int. J. Mol. Sci. 2020, 21, 1601. https://0-doi-org.brum.beds.ac.uk/10.3390/ijms21051601
Frega S, Ferro A, Bonanno L, Guarneri V, Conte P, Pasello G. Lung Cancer (LC) in HIV Positive Patients: Pathogenic Features and Implications for Treatment. International Journal of Molecular Sciences. 2020; 21(5):1601. https://0-doi-org.brum.beds.ac.uk/10.3390/ijms21051601
Chicago/Turabian StyleFrega, Stefano, Alessandra Ferro, Laura Bonanno, Valentina Guarneri, PierFranco Conte, and Giulia Pasello. 2020. "Lung Cancer (LC) in HIV Positive Patients: Pathogenic Features and Implications for Treatment" International Journal of Molecular Sciences 21, no. 5: 1601. https://0-doi-org.brum.beds.ac.uk/10.3390/ijms21051601