治疗艾滋病毒感染者的癌症
1HIV & AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD.
概括
艾滋病毒感染者 (PWH) 面临更高的癌症风险和更低的生存率. 然而,PD-1/PD-L1抑制剂对于与艾滋病毒相关的癌症是安全有效的,这证明PWH应在未来的临床试验中被纳入.
科学领域:
- 在瘤学瘤学.
- 传染性疾病 传染性疾病
- 临床试验 临床试验
背景情况:
- 艾滋病毒感染者 (PWH) 患某些癌症的风险增加,癌症存活率降低,尽管抗逆转录病毒治疗有效.
- 在PWH中管理癌症是复杂的,涉及联合感染,药物相互作用,以及可能被排除在标准治疗和临床试验之外.
- 标准的,全剂量癌症治疗通常被推用于PWH,反映了一般人口的指导方针.
研究的目的:
- 审查艾滋病毒感染者 (PWH) 癌症治疗的现状.
- 评估PD-1和PD-L1抑制剂在癌症PWH中的安全性和有效性.
- 倡导将PWH纳入未来的癌症临床试验.
主要方法:
- 审查有关艾滋病毒相关癌症及其治疗的现有文献.
- 对前性和后性研究对使用抗PD-(L) - 1剂在晚期癌症的PWH中进行分析.
- 检查美国食品和药物管理局 (FDA) 批准的PD-1和PD-L1抑制剂在艾滋病毒相关癌症中的适用情况.
主要成果:
- 针对PD-1和PD-L1的药物具有FDA批准的几种与艾滋病毒相关的癌症的适应症,但PWH被排除在导致这些批准的试验之外.
- 前性和后性研究表明,抗PD-(L) -1药物在各种癌症类型和CD4+T细胞计数中对PWH安全有效.
- 这些发现支持在PWH中使用抗PD-(L) -1剂,用于FDA批准的适用症.
结论:
- 抗PD-(L) -1药物显示出治疗PWH的HIV相关癌症的前景.
- 未来的癌症临床试验必须积极招募PWH,以确保公平获得新疗法.
- 将PWH纳入试验对于促进这一群体癌症治疗至关重要.
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