title: Drug-Drug Interactions Based on Pharmacogenetic Profile between Highly Active Antiretroviral Therapy and Antiblastic Chemotherapy in Cancer Patients with HIV Infection.
abstract: The introduction of Highly Active Antiretroviral Therapy (HAART) into clinical practice has dramatically changed the natural approach of HIV-related cancers. Several studies have shown that intensive antiblastic chemotherapy (AC) is feasible in HIV-infected patients with cancer, and that the outcome is similar to that of HIV-negative patients receiving the same AC regimens. However, the concomitant use of HAART and AC can result in drug accumulation or possible toxicity with consequent decreased efficacy of one or both classes of drugs. In fact, many AC agents are preferentially metabolized by CYP450 and drug-drug interactions (DDIs) with HAART are common. Therefore, it is important that HIV patients with cancer in HAART receiving AC treatment at the same time receive an individualized cancer management plan based on their liver and renal functions, their level of bone marrow suppression, their mitochondrial dysfunction, and their genotype profile. The rationale of this review is to summarize the existing data on the impact of HAART on the clinical management of cancer patients with HIV/AIDS and DDIs between antiretrovirals and AC. In addition, in order to maximize the efficacy of antiblastic therapy and minimize the risk of drug-drug interaction, a useful list of pharmacogenomic markers is provided.
authors.affiliation: Department of Medical Oncology, CRO National Cancer Institute Aviano, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Berretta
authors.affiliation: Department of Biochemistry, Biophysics and General Pathology, Second University of Naples Naples, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Caraglia
authors.affiliation: Department of Medical Oncology, CRO National Cancer Institute Aviano, Italy.
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Martellotta
authors.affiliation: Department of Biochemistry, Biophysics and General Pathology, Second University of Naples Naples, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Zappavigna
authors.affiliation: Department of Biochemistry, Biophysics and General Pathology, Second University of Naples Naples, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Lombardi
authors.affiliation: Hematology and Cellular Immunology (Clinical Biochemistry), A.O. dei Colli Monaldi Hospital Naples, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Fierro
authors.affiliation: Hematology and Cellular Immunology (Clinical Biochemistry), A.O. dei Colli Monaldi Hospital Naples, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Atripaldi
authors.affiliation: Hematology and Cellular Immunology (Clinical Biochemistry), A.O. dei Colli Monaldi Hospital Naples, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Muto
authors.affiliation: Molecular Diagnostics Service, CETAC Research Center Caserta, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Valente
authors.affiliation: Department of Medical Oncology, CRO National Cancer Institute Aviano, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: De Paoli
authors.affiliation: Department of Medical Oncology, CRO National Cancer Institute Aviano, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Tirelli
authors.affiliation: Hematology-Oncology and Stem Cell Transplantation Unit, National Cancer Institute, Fondazione "G. Pascale" IRCCS Naples, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Di Francia
keywords: AIDS; HIV; antiblastic chemotherapy; antiretroviral therapy; cancer; pharmacogenomics; polymorphisms cytochrome P450