Originally published as JCO Early Release 10.1200/JCO.2008.16.8252 on June 30 2008

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AIDS-Related Malignancies: State of the Art and Therapeutic Challenges

Jean-Philippe Spano, Dominique Costagliola, Christine Katlama, Nicolas Mounier, Eric Oksenhendler, David Khayat

From the Service d'Oncologie Médicale and Service de Maladies Infectieuses et Tropicales, Assistance Publique Hôpitaux de Paris, Groupe hospitalier Pitié-Salpêtrière; Université Pierre et Marie Curie, Université Paris; L'Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche Scientifique S 720; Hôpital Saint Louis, Département d'Immunologie Clinique, Paris; and Groupe Hospitalier de Nice, Hôpital de l'Archet, Service d'Hématologie, Nice, France

Corresponding author: Jean-Philippe Spano, MD, PhD, Pitié-Salpêtrière Hospital, Department of Medical Oncology, 47 Blvd de l'Hôpital, 75013 Paris, France; e-mail: jean-philippe.spano{at}psl.ap-hop-paris.fr

Despite the impact of combination antiretroviral therapy (cART) on HIV-related mortality, malignancy remains an important cause of death in the current era. Although the advent of cART has resulted in reductions in the incidence of Kaposi's sarcoma and non-Hodgkin's lymphoma, non–AIDS-defining malignancies present an increased risk for HIV-infected patients, characterized by some common clinical features, generally with a more aggressive behavior and a more advanced disease at diagnosis, which is responsible for poorer patient outcomes. Specific therapeutic recommendations are lacking for these new nonopportunistic malignancies, such as Hodgkin's lymphoma, anal cancer, lung cancer, hepatocarcinoma, and many others. Antiretroviral agents have a propensity for causing drug interactions as a result of their ability to either inhibit or induce the cytochrome P450 (CYP) enzyme system. Because many antineoplastic drugs are also metabolized by the CYP system, coadministration with cART could result in either drug accumulation with increased toxicity, or decreased efficacy of one or both classes of drugs. Further research delineating the combined safety and pharmacokinetics of antiretrovirals and antineoplastic therapy is necessary. Special considerations of these AIDS-related and non–AIDS-related malignancies and their clinical and therapeutic aspects constitute the subject of this review.

published online ahead of print at www.jco.org on June 30, 2008.

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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