Study Reports Exclusion from Trials Responsible for Poor Outcomes in HIV-Positive Cancer Patients

HIV-positive individuals are not usually enrolled in clinical trials, resulting in a knowledge-gap on their treatment options.

HIV-infected people with early stage cancer are two to four times more likely to go untreated for their cancer compared to uninfected patients with cancer, according to a new, large retrospective study.

Journal of Clinical Oncology

Life expectancy for HIV-infected people is now similar to uninfected people, but survival for infected patients who develop cancer is not. Many studies have attempted to understand why HIV-infected cancer patients have worse outcomes; however, this new study, the largest of its size and scope, examined differences in cancer treatment as one potential explanation. It was conducted by researchers in Penn Medicine's Abramson Cancer Center in Philadelphia, Pennsylvania, and the National Cancer Institute (NCI), and published in the (2014; doi:10.1200/JCO.2013.54.8644).

For early stage cancers that have the highest chance of cure with appropriate treatment, those with HIV were twice to four times as likely to not receive appropriate cancer treatment, the researchers found. HIV-infected people with lymphoma, lung cancer, prostate cancer, and colorectal cancer were almost twice as likely to be untreated for cancer, even after considering differences in age, gender, race, and stage.

"In my clinical experience, I have seen uncertainty surrounding treatment of HIV-infected cancer patients," said the study's lead author, Gita Suneja, MD, an adjunct assistant professor in the department of Radiation Oncology at the Perelman School of Medicine at the University of Pennsylvania and in the Abramson Cancer Center. "Patients with HIV have typically been excluded from clinical trials, and therefore oncologists do not know if the best available treatments are equally safe and effective in those with HIV. Many oncologists rely on guidelines based on such trials for treatment decision making, and in the absence of guidance, they may elect not to treat HIV-infected cancer patients due to concerns about adverse side effects or poor survival."

Read the report here: http://bit.ly/WJZ99L

Source: OncologyNurseAdvisor