Abstract
Background: Previous studies have shown that men with HIV and germ cell cancer (HIV-GCC) have inferior overall survival (OS) in comparison with their HIV-negative counterparts. However, little information is available on treatments and outcomes of HIV-GCC in the era of combination antiretroviral therapy (cART). Methods: This study examined men living with HIV who were 18 years old or older and had a diagnosis of histologically proven germ cell cancer (GCC). The primary outcomes were OS and progression-free survival (PFS). Results: Data for 89 men with a total of 92 HIV-GCCs (2 synchronous GCCs and 1 metachronous bilateral GCC) were analyzed; among them were 64 seminomas (70%) and 28 nonseminomas (30%). The median age was 36 years, the median CD4 T-cell count at GCC diagnosis was 420 cells/µL, and 77% of the patients on cART had an HIV RNA load < 500 copies/mL. Stage I disease was found in 44 of 79 gonadal GCCs (56%). Among 45 cases with primary disseminated GCC, 78%, 18%, and 4% were assigned to the good-, intermediate-, and poor-prognosis groups, respectively, of the International Germ Cell Cancer Collaborative Group. Relapses occurred in 14 patients. Overall, 12 of 89 patients (13%) died. The causes of death were refractory GCC (n = 5), an AIDS-defining illness (n = 3), and other causes (n = 4). After a median follow-up of 6.5 years, the 5- and 10-year PFS rates were 81% and 73%, respectively, and the 5- and 10-year OS rates were 91% and 85%, respectively. Conclusions: The 5- and 10-year PFS and OS rates of men with HIV-GCC were similar to those reported for men with HIV-negative GCC. Patients with HIV-GCC should be managed identically to HIV-negative patients. Lay Summary: Men living with HIV are at increased risk for germ cell cancer (GCC). Previous studies have shown that the survival of men with HIV-associated germ cell cancer (HIV-GCC) is poorer than the survival of their HIV-negative counterparts. This study examined the characteristics, treatments, and outcomes of 89 men with HIV-GCC in the era of effective combination antiretroviral therapies. The long-term outcomes of men with HIV-GCC were similar to those reported for men with HIV-negative GCC. Patients with HIV-GCC should be managed identically to HIV-negative patients.
Originalsprog | Engelsk |
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Tidsskrift | Cancer |
Vol/bind | 128 |
Udgave nummer | 2 |
Sider (fra-til) | 260-268 |
Antal sider | 9 |
ISSN | 0008-543X |
DOI | |
Status | Udgivet - 2022 |
Bibliografisk note
Funding Information:Marcus Ulrich Hentrich has served on advisory boards for Amgen, Janssen, BMS, Sanofi, AbbVie, Hexal, and Jazz Pharmaceuticals; has served on speaker bureaus for Amgen, Janssen, Sanofi, Takeda, and BMS; and has received travel grants from Amgen, Janssen, Takeda, Celgene, and Sanofi. Mark Bower reports lecture honoraria from EUSA, ViiV, Merck, and Gilead. Gedske Daugaard has served on boards for Astellas, Bayer, Bristol, Janssen, and Sanofi. Albrecht Stoehr has served on advisory boards for ViiV, MSD, Gilead, and AbbVie and has received travel grants from AbbVie, Janssen, and Gilead. Julia Heinzelbecker has served on the speaker bureau for Roche and has received travel grants from Ipsen, Pfizer, and Bayer. Klaus‐Peter Dieckmann declares an ownership interest in and has served on advisory boards for miRdetect GmbH. Andrea Necchi declares that an immediate family member is employed by and holds ownership interests in Bayer; he has served as an consultant for Immunomedics, MSD, Roche, Bayer, AstraZeneca, Clovis Oncology, Janssen, Incyte, Seattle Genetics/Astellas, BMS, Rainer Therapeutics, GlaxoSmithKline, and Ferring; he has received travel grants from Roche, MSD, AstraZeneca, Janssen, and Rainer Therapeutics; he has received honoraria from Roche, Merck, AstraZeneca, Janssen, Foundation Medicine, and BMS; and he has received research funding from MSD, AstraZeneca, and Ipsen. Pablo Maroto Rey has served as a consultant for Bayer, Ipsen, Janssen, Astellas Oncology, BMS, Novartis, Pfizer, and Roche; has received research funding from Bayer and Roche; and has received travel grants from Ipsen, Janssen, and Pfizer. Jürgen Kurt Rockstroh has received honoraria from Gilead, Janssen, Merck, and ViiV Healthcare. Margarida Brito reports participation on boards for Roche and Novartis. Christian Hoffmann has served as a consultant for EUSA Pharma, Gilead, Hexal, Hormosan, Janssen, ViiV Healthcare, and MSD Brazil; has served on speaker bureaus for EUSA Pharma, Gilead, Hexal, Hormosan, Janssen, ViiV Healthcare, and MSD Brazil; has received research funding from EUSA Pharma, Gilead, Janssen, ViiV Healthcare, and MSD Brazil; and has received travel grants from EUSA Pharma, Gilead, Hexal, Hormosan, Janssen, ViiV Healthcare, and MSD Brazil. The other authors made no disclosures.
Publisher Copyright:
© 2021 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society