NCCN Provides New Guidelines for Patients Living With HIV Diagnosed With Cancer

02/27/18

The National Comprehensive Cancer Network (NCCN) has released the first-ever clinical practice guidelines addressing patients living with HIV who are diagnosed with cancer to help them receive safe and necessary treatment.

People living with HIV are diagnosed with cancer at an approximately 50% higher rate than the general population. However, these patients are two-to-three times more likely to receive no cancer treatment compared with uninfected patients.

“Although we don’t yet know all the reasons for these large differences in cancer treatment, the lack of clinical management guidelines available to clinicians has been shown to be one contributing factor,” said Gita Suneja, MD, Duke Cancer Institute, co-chair of the NCCN guidelines panel for cancer in people living with HIV, in a press release (February 27, 2018).

The NCCN convened a panel to design these guidelines. The panel consisted of oncologists, radiologists, infectious disease specialists, surgical oncologists, pharmacists, and a patient advocate.

The most noteworthy recommendations in the guidelines are below:

·      Most patients living with HIV who develop cancer should be offered the same cancer therapies as HIV negative individuals, and modifications to cancer treatment should not be made solely on the basis of HIV status

·      Care for patients diagnosed with HIV should be co-managed with an oncologist and an HIV specialist

·      Oncologists and HIV clinicians, along with HIV and oncology pharmacists, if available, should review proposed cancer therapy and antiretroviral therapy for possible drug-drug interactions and overlapping toxicity concerns prior to initiation of therapy

The most common types of cancer occurring in people living with HIV are non-Hodgkin lymphoma, Kaposi sarcoma, lung cancer, anal cancer, prostate cancer, liver cancer, colorectal cancer, Hodgkin lymphoma, oral/pharyngeal cancer, female breast cancer, and cervical cancer. The new guidelines provide specific treatment recommendations for non-small cell lung cancer, anal cancer, Hodgkin lymphoma, and cervical cancer.

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“Treating people living with HIV for cancer is a relatively new concern. It’s both a testament to the successes of HIV treatments in recent years, and a reminder that the quest for healthier outcomes is ongoing,” said Robert W Carlson, MD, chief executive officer, NCCN, in a statement (February 27, 2018). “That’s why at NCCN we are always seeking new ways to expand and update the resources that we offer.”—Zachary Bessette