Full-dose chemotherapy regimen appears safe for patients with HIV and cancer

There’s a dearth of research about the effectiveness of cancer treatment in people with HIV. But today, many people with HIV live long lives, and the lack of research needs to be addressed. In order to fill this gap, a team of researchers evaluated the efficacy of a chemotherapy regimen commonly used to treat advanced cancer in a group of patients living with HIV. The researchers investigated the safety and tolerability of an active regimen incorporating full doses of paclitaxel and carboplatin (PCb) and published their findings in The Oncologist.

For the pilot trial, the researchers recruited 16 patients to undergo 64 cycles of PCb. They stratified the patients into a cohort of 6 patients who were receiving antiretroviral therapy (ART), including the CYP3AR inhibitor ritonavir, and a cohort of 10 patients who received ART without ritonavir.

As part of the protocol, the patients received carboplatin and paclitaxel intravenously every 3 weeks for a maximum of 6 cycles, and the patients were assessed every 2 cycles with radiological studies. The researchers also monitored their tumor response. All of the patients in the study tolerated at least 2 cycles, and the median number of cycles was 4.

They found that 3 patients experienced durable partial responses that ranged from 16 to 22 months and 6 patients experienced disease stabilization. “We found that 10% of the patients experienced grade 3 or higher toxicities, the most common of which were granulocytopenia (40%), infection (15%) and anemia (15%),” the researchers wrote.

Although the researchers noted that the prospective nature of the study was a strength, the small sample size was a limitation. However, the researchers were able to follow the patients over time and capture adverse events over more chemotherapy cycles.

“We conclude that full-dose PCb may be administered to people living with HIV and cancer in clinical practice, regardless of ART, with expected broad clinical activity,” the researchers concluded. “Routine use of GCSF or empiric dose reductions for presumed risk associated with PCb does not seem to be necessary based on our findings.”

Disclosures: Some authors have declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

By Jennifer Larson

Reference

Haigentz M, Moore P, Bimali M, et al. Safety and tolerability of carboplatin and paclitaxel in cancer patients with HIV (AMC–78), an AIDS Malignancy Consortium study. Oncologist. Published online April 16, 2022. doi:10.1093/oncolo/oyac004