Cancer and HIV safe chemotherapy despite the risk of drug interactions

The administration of the anticancer sunitinib is safe in patients with HIV (human immunodeficiency virus), a population that oncologists do not yet know good deal, according to preliminary results of a study that was presented the meeting of the American Society of Clinical Oncology (ASCO) in Chicago.
For reasons that remain unclear, cancers unrelated to AIDS increased alarmingly in patients infected with HIV. In addition, these cancers appear more aggressive, occur at younger ages and are more at risk for recurrence, noted John Deeken, Lombardi Comprehensive Cancer Center at Georgetown University in Washington, and colleagues.

Compared to a person HIV, an HIV + patient has a risk multiplied by 13-31 to develop Hodgkin's lymphoma, seven to be achieved by liver cancer, and three suffer from lung cancer or cancer of the head and neck, cited researchers.

"However, many oncologists do not know how to treat these cancers, and patients are excluded from clinical trials," they tell us. "Although these precautions are understandable, they may not be scientifically based and be fundamentally unfair", they believe.

"Treating these patients is a major challenge because antiretroviral drugs are known to cause drug interactions. Such interactions with anticancer agents may cause serious side effects or toxicities for patients," they explain.

They then sought to assess the safety of an anti-cancer agent sunitinib in HIV + patients. They chose this drug because it is recommended in the treatment of kidney cancer, the incidence is higher in HIV + patients, and it is currently being studied for other cancers.

The researchers identified two groups of HIV + patients: those who were receiving antiretroviral therapy including non-nucleoside reverse transcriptase inhibitors (NNRTIs) and those whose treatment was based on a protease inhibitor, ritonavir.

Preliminary results obtained in nine patients, treatment with sunitinib was well tolerated in HIV + patients receiving NNRTIs. The antiretroviral cocktail administered to some patients may even promote the activation of sunitinib liver enzyme, increasing the effectiveness of the drug.

In the second group, the researchers found a strong activation of sunitinib at low doses, suggesting that these patients would benefit from an even lower doses of chemotherapy.

The result of the study will evaluate the effect of different doses of sunitinib, analyzing both their efficacy and toxicity.

"We are at the beginning, but we hope that this study will help patients get the treatment they want and they need, and that will give them access to clinical trials that test the newer agents "the researchers conclude.