Clinical Trials for Treatment and Prevention of HIV-Associated Malignancies in Sub-Saharan Africa: Building Capacity and Overcoming Barriers

Author:

Lin Lilie L.1,Lakomy David S.12,Chiao Elizabeth Y.34,Strother Robert M.5,Wirth Meg6,Cesarman Ethel7,Borok Margaret8,Busakhala Naftali9,Chibwesha Carla J.101112,Chinula Lameck1213,Ndlovu Ntokozo14,Orem Jackson15,Phipps Warren151617,Sewram Vikash18,Vogt Samantha L.19,Sparano Joseph A.20,Mitsuyasu Ronald T.21,Krown Susan E.22,Gopal Satish23

Affiliation:

1. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX

2. Dartmouth Geisel School of Medicine, Hanover, NH

3. Department of General Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX

4. Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX

5. Department of Medicine, University of Otago, Christchurch, New Zealand

6. The Emmes Corporation, Callaway, MD

7. Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY

8. Department of Medicine, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe

9. Department of Pharmacology and Toxicology, Moi University School of Medicine, Eldoret, Kenya

10. Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, NC

11. Clinical HIV Research Unit, Department of Medicine, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa

12. Division of Global Women’s Health, Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC

13. UNC Project-Malawi, Lilongwe, Malawi

14. Department of Radiology, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe

15. Uganda Cancer Institute, Kampala, Uganda

16. Department of Medicine, University of Washington, Seattle, WA

17. Fred Hutchinson Cancer Research Center, Seattle, WA

18. African Cancer Institute, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa

19. Department of Medical Oncology, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD

20. Montefiore-Einstein Cancer Center, Montefiore Medical Center, Bronx, NY

21. Center for Clinical AIDS Research and Education, University of California, Los Angeles, Los Angeles, CA

22. AIDS Malignancy Consortium, New York, NY

23. Center for Global Health, National Cancer Institute, Rockville, MD

Abstract

PURPOSE The aim of this study was to review the current status of clinical trials for HIV-associated malignancies in people living with HIV in sub-Saharan Africa (SSA) and efforts made by the AIDS Malignancy Consortium (AMC) to build capacity in SSA for HIV malignancy research. METHODS All malignancy-related clinical trials in 49 SSA countries on ClinicalTrials.gov were reviewed and evaluated for inclusion and exclusion criteria pertaining to HIV status. Additional studies by AMC in SSA were compiled from Web-based resources, and narrative summaries were prepared to highlight AMC capacity building and training initiatives. RESULTS Of 96 cancer trials identified in SSA, only 11 focused specifically on people living with HIV, including studies in Kaposi sarcoma, cervical dysplasia and cancer, non-Hodgkin lymphoma, and ocular surface squamous neoplasia. Recognizing the increasing cancer burden in the region, AMC expanded its clinical trial activities to SSA in 2010, with 4 trials completed to date and 6 others in progress or development, and has made ongoing investments in developing research infrastructure in the region. CONCLUSION As the HIV-associated malignancy burden in SSA evolves, research into this domain has been limited. AMC, the only global HIV malignancy-focused research consortium, not only conducts vital HIV-associated malignancies research in SSA, but also develops pathology, personnel, and community-based infrastructure to meet these challenges in SSA. Nonetheless, there is an ongoing need to build on these efforts to improve HIV-associated malignancies outcomes in SSA.

Publisher

American Society of Clinical Oncology (ASCO)

Subject

Cancer Research,Oncology

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