Lung Cancer in HIV-Infected Patients in the Era of Highly Active Antiretroviral Therapy

Hakimian, Roger; Fang, Hong-Bin; Thomas, Leno; Edelman, Martin J.

doi:10.1097/01.jto.0000263707.31202.d7

Cited by 50 publications

(45 citation statements)

References 22 publications

(17 reference statements)

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“…14,40,[54][55][56][57][58][59][60] With the exception of two retrospective studies, squamous cell cancer is the second commonest histological type (19-36%) in HIV-lung cancer patients, comparable to the 25% squamous cell cancer reported in HIV indeterminate individuals in the SEER data set. 49,53 The predominance of adenocarcinoma among HIVinfected individuals mirrors the changes in the distribution of the histological types of lung cancer seen in the general population.…”

Section: Pathological Findingsmentioning

confidence: 82%

“…40,[52][53][54][55][56][57][58][59][60][61][62] Yet, in a recent registry linkage study, the difference in the age at diagnosis of lung cancer was relatively modest between persons with AIDS and the general population (50 vs. 54 years) after adjusting for the underlying population structures. 31 In HIV-infected patients with lung cancer, men are significantly overrepresented compared to women, with a male-female sex ratio of 5-10:1.…”

Section: Clinical Characteristicsmentioning

confidence: 98%

“…Perhaps these patients are better able to tolerate more active chemotherapy than in the pre-HAART era. 60,77,78 There are potential drug-drug interactions and cumulative toxicity concerns when HAART is combined with systemic chemotherapy. Etoposide, taxanes, vinca alkaloids and anilinoquinazolines erlotinib and gefitinib are metabolized by cytochrome P450.…”

Section: Treatment and Outcomementioning

confidence: 99%

See 2 more Smart Citations

Lung Cancer in HIV Infection

Mani

Aboulafia

2014

Cancers in People With HIV and AIDS

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Lung cancer is the most prevalent non-AIDS-defining malignancy in the HAART era. Smoking plays a significant role in the development of HIV-associated lung cancer, but the cancer risk is 2-4 times greater in HIV-infected persons than in the general population, even after adjusting for smoking intensity and duration. Lung cancer is typically diagnosed a decade or more earlier among HIV-infected persons (mean age, 46 years) compared to those without HIV infection. Adenocarcinoma is the commonest histological subtype, and the majority of patients are diagnosed with locally advanced or metastatic carcinoma. Since pulmonary infections are common among HIV-infected individuals, clinicians may not suspect lung cancer in this younger patient population. Surgery with curative intent remains the treatment of choice for early stage disease. Although there is increasing experience in using radiation and chemotherapy for HIV-infected patients who do not have surgical options, there is a need for prospective studies for this population frequently excluded from participating in cancer trials. Evidence-based treatments for smoking-cessation with demonstrated efficacy in the general population must be routinely incorporated into the care of HIV-positive smokers.

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Section: Pathological Findingsmentioning

confidence: 82%

Section: Clinical Characteristicsmentioning

confidence: 98%

Section: Treatment and Outcomementioning

confidence: 99%

See 1 more Smart Citation

Lung Cancer in HIV Infection

Mani

Aboulafia

2014

Cancers in People With HIV and AIDS

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“…Lung cancer is typically diagnosed a decade earlier (mean age 45 years) in the HIV-infected population and most of the time patients have advanced-stage disease. Several publications in the 1990s reported unfavourable outcomes in the HIVpositive population [181,182]. In the era of highly active antiretroviral therapy, it seems that survival following lung resection should be comparable to that of patients without HIV infection, although this has been questioned recently [181,183].…”

Section: Lung Resections In Hiv-positive Patientsmentioning

confidence: 99%

Surgery for nonsmall cell lung cancer

Lang-Lazdunski

2013

Eur Respir Rev

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Surgery remains the best curative option in patients with early stage lung cancer (stage I and II). Developments in minimally invasive techniques now allow surgeons to perform lung resections on elderly patients, patients with poor pulmonary function or significant cardiopulmonary comorbidities. New techniques, such as stereotactic radiotherapy and ablative procedures, are being evaluated in early-stage lung cancer and may represent an alternative to surgery in patients unfit for lung resection. Perioperative mortality rates have dropped significantly at most institutions in the past two decades and complications are managed more efficiently. Progress in imaging and staging techniques have helped cut futile thoracotomy rates and offer patients the most adequate treatment options. Large randomised trials have helped clarify the role of neoadjuvant, induction and adjuvant chemotherapy, as well as radiotherapy. Surgery remains an essential step in the multimodality therapy of selected patients with advanced-stage lung cancer (stage III and IV). Interventional and endoscopic techniques have reduced the role of surgery in the diagnosis and staging of nonsmall cell lung cancer, but surgery remains an important tool in the palliation of advanced-stage lung cancer. Large national/international surgical databases have been developed and predictive risk-models for surgical mortality/morbidity published by learned surgical societies. Nonetheless, lung cancer overall survival rates remain deceptively low and it is hoped that early detection/screening, better understanding of tumour biology and development of biomarkers, and development of efficient targeted therapies will help improve the prognosis of lung cancer patients in the next decade. @ERSpublications Despite progress in surgical techniques, radiotherapy techniques and targeted therapy, lung cancer prognosis remains poor

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“…There is also an increased incidence of NSCLC in patients with HIV and in patients with tuberculosis [4][5][6][7] Genetic factors can also affect both the risk and prognosis of NSCLC. Although the genetic basis of lung cancer (including genetic markers) are still being elucidated, there is a clearly established familial risk.…”

Section: Introductionmentioning

confidence: 99%