Chemotherapy and Interactions with Combination Antiretroviral Therapy
Combination antiretroviral therapy (cART) has markedly reduced morbidity and mortality of AIDS-related complications in patients with HIV. Despite the overall success of cART, hematological malignancies remain a common source of morbidity and mortality. In this chapter, we discuss the management of cART in relation to antineoplastic agents and potential pharmacological interactions between cART and antineoplastic agents and consider how to combine cART and antineoplastic agents in patients with HIV.
KeywordsVinca Alkaloid Drug Interaction Potential CYP450 Isozyme cART Regimen Unconjugated Hyperbilirubinemia
- 1.Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. Available at http://www.aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf. Accessed 27 Nov 2014.
- 2.Montoto S, Shaw K, Okosun J, et al. HIV status does not influence outcome in patients with classical Hodgkin lymphoma treated with chemotherapy using doxorubicin, bleomycin, vinblastine, and dacarbazine in the highly active antiretroviral therapy era. J Clin Oncol. 2012;30:4111–6.CrossRefPubMedGoogle Scholar
- 8.Hentrich M, Berger M, Wyen C, et al. Stage-adapted treatment of HIV-associated Hodgkin lymphoma: results of a prospective multicenter study. J Clin Oncol. 2012;30:4117–23.Google Scholar
- 13.Ezzat HM, Cheung MC, Hicks LK, et al. Incidence, predictors and significance of severe toxicity in patients with human immunodeficiency virus-associated Hodgkin lymphoma. Leuk Lymphoma. 2012;53:2390–6.Google Scholar
- 14.Cingolani A, Torti L, Pinnetti C, et al. Detrimental clinical interaction between ritonavir-boosted protease inhibitors and vinblastine in HIV-infected patients with Hodgkin’s lymphoma. AIDS. 2010;24:2408–12.Google Scholar
- 15.Cianfrocca M, Lee S, Von Roenn J, et al. Pilot study evaluating the interaction between paclitaxel and protease inhibitors in patients with human immunodeficiency virus-associated Kaposi’s sarcoma: an Eastern Cooperative Oncology Group (ECOG) and AIDS Malignancy Consortium (AMC) trial. Cancer Chemother Pharmacol. 2011;68:827–33.Google Scholar
- 16.Rudek MA, Chang CY, Steadman K, et al. Combination antiretroviral therapy (cART) component ritonavir significantly alters docetaxel exposure. Cancer Chemother Pharmacol. 2014;73:729–36.Google Scholar
- 17.Koon HB, Krown SE, Lee JY, et al. Phase II trial of imatinib in AIDS-associated Kaposi’s sarcoma: AIDS Malignancy Consortium Protocol 042. J Clin Oncol. 2014;32:402–8.Google Scholar
- 18.Rudek MA, Moore PC, Mitsuyasu RT, et al. A phase 1/pharmacokinetic study of sunitinib in combination with highly active antiretroviral therapy in human immunodeficiency virus-positive patients with cancer: AIDS Malignancy Consortium trial AMC 061. Cancer. 2014;120:1194–1202.Google Scholar
- 19.Pillai VC, Venkataramanan R, Parise RA, et al. Ritonavir and efavirenz significantly alter the metabolism of erlotinib–an observation in primary cultures of human hepatocytes that is relevant to HIV patients with cancer. Drug Metab Dispos. 2013;41:1843–51.Google Scholar
- 20.Pillai VC, Parise RA, Christner SM, et al. Potential interactions between HIV drugs, ritonavir and efavirenz and anticancer drug, nilotinib–a study in primary cultures of human hepatocytes that is applicable to HIV patients with cancer. J Clin Pharmacol. 2014;54:1272–9.Google Scholar
- 21.Rudek MA, Flexner C, Ambinder RF. Use of antineoplastic agents in patients with cancer who have HIV/AIDS. Lancet Oncol. 2011;12:905–12.Google Scholar
- 22.Beumer JH, Venkataramanan R, Rudek MA. Pharmacotherapy in cancer patients with HIV/AIDS. Clin Pharmacol Ther. 2014;95:370–2.Google Scholar