Berretta Massimiliano, Lleshi Arben, Cappellani Alessandro, Bearz Alessandra, Spina Michele, Talamini Renato, Cacopardo Bruno, Nunnari Giuseppe, Montesarchio Vincenzo, Izzi Immacolata, Lanzafame Massimiliano, Nasti Guglielmo, Basile Francesco, Berretta Salvatore, Fisichella Rossella, Schiantarelli C Clara, Garlassi Elisa, Ridolfo Annalisa, Guella Lorenza, Tirelli Umberto
Department of Medical Oncology, National Cancer Institute - Centro di Riferimento Oncologico, IRCCS, 33081 Aviano (PN), Italy.
Curr HIV Res. 2010 Apr;8(3):218-22. doi: 10.2174/157016210791111061.
Although FOLFOX4 is considered the standard chemotherapy regimen for colorectal cancer (CRC), few data are available on its results in human immunodeficiency (HIV)-related CRC. The results were analyzed to evaluate feasibility and activity of FOLFOX4 plus highly active antiretroviral therapy (HAART) in metastatic CRC (mCRC) HIV-seropositive patients.
From January 2002 to March 2007, 24 patients were selected among the CRC HIV-seropositive patients treated with FOLFOX4 and concomitant HAART within the Italian Cooperative Group on AIDS and Tumors (GICAT).
Four median cycles of chemotherapy were administered; the most common severe toxicity was neutropenia (37.5%). An overall response rate of 50% was observed; 4.2% of patients achieved complete response and 45.8% partial response. No opportunistic infections occurred during or immediately after chemotherapy. The median CD4+ count was 380 (range 220-570) at diagnosis.
To our knowledge, this is the largest study describing activity and tolerability of FOLFOX4 and HAART, in this setting. FOLFOX4 plus concomitant HAART resulted feasible and active also in HIV-seropositive patients. Moreover, the concomitant use of HAART did not to seem to increase the FOLFOX4 toxicity. This study suggests the good tolerability of the FOLFOX4, making it a reasonable option for combination with HAART.
尽管FOLFOX4被认为是结直肠癌（CRC）的标准化疗方案，但关于其在人类免疫缺陷病毒（HIV）相关结直肠癌中的疗效数据较少。分析其结果以评估FOLFOX4联合高效抗逆转录病毒疗法（HAART）在转移性结直肠癌（mCRC）HIV血清阳性患者中的可行性和活性。
2002年1月至2007年3月期间，在意大利艾滋病与肿瘤合作组（GICAT）中，从接受FOLFOX4和同步HAART治疗的HIV血清阳性CRC患者中选取了24例患者。
给予了四个化疗中位周期；最常见的严重毒性是中性粒细胞减少（37.5%）。观察到总缓解率为50%；4.2%的患者达到完全缓解，45.8%为部分缓解。化疗期间或化疗后立即未发生机会性感染。诊断时CD4 + 细胞计数中位数为380（范围220 - 570）。
据我们所知，这是在这种情况下描述FOLFOX4和HAART活性及耐受性的最大规模研究。FOLFOX4联合同步HAART在HIV血清阳性患者中也显示出可行性和活性。此外，同步使用HAART似乎并未增加FOLFOX4的毒性。这项研究表明FOLFOX4具有良好的耐受性，使其成为与HAART联合使用的合理选择。
