|Title||Cisplatin and radiation therapy in HIV-positive women with locally advanced cervical cancer in sub-Saharan Africa: A phase II study of the AIDS malignancy consortium.|
|Publication Type||Journal Article|
|Year of Publication||2019|
|Authors||Einstein, MH, Ndlovu, N, Lee, J, Stier, EA, Kotzen, J, Garg, M, Whitney, K, Lensing, SY, Tunmer, M, Kadzatsa, W, Palefsky, J, Krown, SE|
|Date Published||2019 04|
|Keywords||Adult, Anti-Retroviral Agents, Antineoplastic Agents, Chemoradiotherapy, Cisplatin, Female, HIV Infections, Humans, Middle Aged, Neoplasm Staging, Prospective Studies, Radiation-Sensitizing Agents, Uterine Cervical Neoplasms|
PURPOSE: To determine the feasibility, safety, and tolerability of concomitant chemoradiotherapy administered at standard doses in HIV-infected women with locally-advanced cervical cancer (LACC) receiving antiretroviral therapy (ART).
PATIENTS AND METHODS: Eligible participants had HIV infection and untreated, histologically-confirmed, invasive carcinoma of the uterine cervix, FIGO stages IB2, IIA (if tumor >4 cm), IIB, IIIA, IIIB, or IVA and met standard eligibility criteria. Subjects were prescribed 41.4-45 Gy external beam radiation therapy followed by high dose rate brachytherapy concomitant with up to six weekly doses of cisplatin 40 mg/m2 and were followed for 12 months.
RESULTS: Sixty-four women were screened at two sites in sub-Saharan Africa, of whom 40 eligible participants were enrolled, for a screening ratio of 1.60. Of the 38 eligible participants who initiated study treatment, 31 (82%) completed treatment. By the 12-month follow-up visit, 7 women had died of disease and 29 of 31 (94%) returned for follow-up. One-year progression-free survival was 76.3% (95% CI, 59.4-86.9%), and did not significantly differ according to stage at entry (p = 0.581). Participant-reported adherence to ART was high; by 12 months, 93% of participants had an undetectable viral load. The most common grade 3 or 4 adverse event was decreased lymphocyte count that affected all treated participants. Non-hematologic serious adverse events were similar to those observed in women with LACC without HIV infection.
CONCLUSIONS: The majority of HIV-infected women with LACC can complete concomitant chemoradiotherapy with the same cisplatin dose used in HIV-uninfected women with comparable tolerability and high ART adherence while on treatment.
|Alternate Journal||Gynecol. Oncol.|
|PubMed Central ID||PMC6430646|
|Grant List||U01 AI027660 / AI / NIAID NIH HHS / United States |
UM1 CA121947 / CA / NCI NIH HHS / United States