Nevirapine toxicity in non-HIV cancer patients.
BACKGROUND
Nevirapine (NVP) is a nonnucleoside reverse transcriptase inhibitor used in HIV patients and recently evaluated as a differentiating and antiproliferative agent in human malignancies. However, while NVP is a safe treatment in immunocompromised patients, NVP-containing regimens have been associated with severe immune-mediated toxicities in non-HIV individuals.


RESULTS
We describe the toxicity profile of single-agent NVP in 6 non-HIV cancer patients treated for a median period of 7.3 months (range 1-24), reporting only a reversible grade III increase in glutamyl transpeptidase and glutamic pyruvic transaminase serum values. Interestingly, NVP treatment correlates with either a decrease in CD8+ T cell counts or a parallel increase in CD4/CD8 ratio, antithyroglobulin and antithyroid peroxidase autoantibody titers.


CONCLUSIONS
These results, although obtained in a small cohort of patients, suggest that the toxicity profile of single-agent NVP may be worth testing in a phase I/II study in non-HIV cancer patients and that NVP toxicity may depend on its capacity to trigger autoimmune responses in susceptible individuals.
Landriscina
Matteo
M
Clinical Oncology, Department of Medical Sciences, University of Foggia, Foggia, Italy. m.landriscina@unifg.it
Fabiano
Annarita
A
Lombardi
Valentina
V
Santodirocco
Michele
M
Piscazzi
Annamaria
A
Fersini
Alberto
A
De Vis
Koen
K
Barone
Carlo
C
Cignarelli
Mauro
M
D000368:Aged; D015658:HIV Infections; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D019829:Nevirapine / Q000009:adverse effects*; D013964:Thyroid Neoplasms / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology
D019829:Nevirapine