Oxaliplatin based chemotherapy and concomitant highly active antiretroviral therapy in the treatment of 24 patients with colorectal cancer and HIV infection.
BACKGROUND
Although FOLFOX4 is considered the standard chemotherapy regimen for colorectal cancer (CRC), few data are available on its results in human immunodeficiency (HIV)-related CRC. The results were analyzed to evaluate feasibility and activity of FOLFOX4 plus highly active antiretroviral therapy (HAART) in metastatic CRC (mCRC) HIV-seropositive patients.


METHODS
From January 2002 to March 2007, 24 patients were selected among the CRC HIV-seropositive patients treated with FOLFOX4 and concomitant HAART within the Italian Cooperative Group on AIDS and Tumors (GICAT).


RESULTS
Four median cycles of chemotherapy were administered; the most common severe toxicity was neutropenia (37.5%). An overall response rate of 50% was observed; 4.2% of patients achieved complete response and 45.8% partial response. No opportunistic infections occurred during or immediately after chemotherapy. The median CD4+ count was 380 (range 220-570) at diagnosis.


CONCLUSIONS
To our knowledge, this is the largest study describing activity and tolerability of FOLFOX4 and HAART, in this setting. FOLFOX4 plus concomitant HAART resulted feasible and active also in HIV-seropositive patients. Moreover, the concomitant use of HAART did not to seem to increase the FOLFOX4 toxicity. This study suggests the good tolerability of the FOLFOX4, making it a reasonable option for combination with HAART.
Department of Medical Oncology, National Cancer Institute - Centro di Riferimento Oncologico, IRCCS, 33081 Aviano (PN), Italy. mberretta@cro.it
Massimiliano
M
Berretta
Arben
A
Lleshi
Alessandro
A
Cappellani
Alessandra
A
Bearz
Michele
M
Spina
Renato
R
Talamini
Bruno
B
Cacopardo
Giuseppe
G
Nunnari
Vincenzo
V
Montesarchio
Immacolata
I
Izzi
Massimiliano
M
Lanzafame
Guglielmo
G
Nasti
Francesco
F
Basile
Salvatore
S
Berretta
Rossella
R
Fisichella
Clara
C
Schiantarelli C
Elisa
E
Garlassi
Annalisa
A
Ridolfo
Lorenza
L
Guella
Umberto
U
Tirelli
D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects / Q000379:methods; D015179:Colorectal Neoplasms / Q000150:complications* / Q000188:drug therapy* / Q000556:secondary; D004358:Drug Therapy / Q000379:methods; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects / Q000627:therapeutic use; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D007558:Italy; D002955:Leucovorin / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome
D019380:Anti-HIV Agents; D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil