WS6-4 - Chemotherapy for Non-Aids Defining Cancers, Focused on Lung Cancer

Abstract

HIV infection has become a chronic disease with the advent of combination antiretroviral therapy. As the result of long survival among the patients living with HIV, the death by non-HIV defining cancers is increasing because of their aging. Non-AIDs defining hematological malignancies have been relatively reported, however, solid tumors, mainly lung cancer, are recently increasing as well. In Japan, the cancer patients living with HIV are also increasing although treatment is still limited in specific hospitals, whereas HIV infection is becoming a “not-rare-complication” in the United States. Lung cancer patients living with HIV is associated with a high frequency of smoking, whereas hepatocellular carcinoma and anal cancer/cervical cancer are associated with HBV and HPV, respectively.The prognosis of the lung cancer patients living with HIV is extremely poor compared to those of the non-HIV population. It was controversial whether chemotherapy for lung cancer patients living with HIV will be of clinical benefit because of increased toxicities related to interactions with antiretroviral therapy, weakening immunity, decreased bone marrow reserve or other organ functions. However, recent treatment progress for the cancer patients living with HIV has led us to believe in improving the prognosis, especially the progress in this decade of chemotherapy for advanced NSCLC among non-HIV population with the advent of molecular targeted drugs or diverse treat strategies in combination with chemotherapy agents.Still, it remains unclear whether adopting the cancer guidelines of standard of care for non-HIV cancer patients is beneficial or not, because the cancer patients living with HIV has been excluded from most clinical trials. Either way, cancer treatment has become specified and more diverse, so clinical management should be done by medical oncologists. Additionally, collaborative team treatment is also essential for cancer patients living with HIV.