Post on 14-Jan-2016
description
National Cancer Institute HIV/AIDS Cancer
Programs
Mostafa Nokta, MD Ph.D.
Chief, AIDS Cancer Clinical Program
Office of HIV and AIDS Malignancy
National Cancer Institute
Nati
onal
Can
cer I
nstit
ute
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Institutes of Health
Cancers in HIV Disease
AIDS-Defining Virus Kaposi’s Sarcoma HHV-8 Non-Hodgkin’s Lymphoma EBV, HHV-8
(systemic and CNS) Invasive Cervical Carcinoma HPVNon-AIDS Defining Anal Cancer HPV Hodgkin’s Disease EBV Leiomyosarcoma (pediatric) EBV Squamous Conjunctival Carcinoma HPV (?) Hepatoma HBV, HCV
Change in Incidence of Cancers in HIV in the cART Era in USA
Kaposi’s sarcoma CNS Lymphoma Lymphoma (NHL and CNS) Lymphoma (HD) Anal Cancer Lung Cancer Cervical Cancer Breast Hepatoma
Patel P et al, Ann Intern Med 2008;148:728-736
Dual Burden of KSHV and HIV Infection in Africa Fuel an Epidemic of Kaposi’s Sarcoma
HIV KS KS Incidence
Office of HIV & AIDS Malignancy
AIDS Malignancy Program
AIDS Cancer Clinical Program
• CFAR• WIHS• MACS• IeDEA• AITRP
• AIDS Malignancy Consortium (AMC)• ACSR•INCTR•ACTG• SPOREs (Lung, Lymphoma, Head & Neck)
AIDS Malignancy Clinical Trials Consortium
AIDS Malignancy Consortium (AMC)
Evaluate clinical interventions for the treatment and prevention of malignancies in people with HIV
Investigate the biology of these malignancies in the context of clinical trials
Conduct Phase I, II and III clinical trials Address issues of international importance in HIV
associated malignancies Contribute specimens and clinical data to the
ACSR
AMC International Objectives
Assist with capacity building in developing nations for international HIV-related cancers
Develop AMC-sponsored and co-sponsored collaborative studies with emphasis on trials that:
- Employ hypothesis-driven, scientifically sound, locally relevant and feasible therapies
- Address important pathogenesis-based questions - Utilize the unique scientific expertise of the AMC
Current International Protocols
Protocol Project Site(s) CommentAMC 049 Sunitinib in AIDS KS Uganda, Kenya Active
AMC 050 KSHV viral transcription Brazil Active
AMC 054 Quadrivalent HPV vaccine IndiaLocal Gov
Review
AMC 055 Indinavir endemic KS Uganda Active
AMC 056 Indinavir endemic KS ZimbabweCTEP/IRB
review
AMC/ACTG 5263/5264
Treatment of early and late KS
Several sites in Africa
In development
AMCOral chemo and Modified
CHOP for AIDS NHLTBD In development
AMC International Sites
Uganda, Kampala Kenya, Nairobi Zimbabwe, Harare India, Mumbai, Chennai, Tamil Nadu Brazil, Sao Paulo Australia, Darling Hurst, NSW Dr. Mostafa Nokta, Noktam@mail.nih.gov
Dr. Ron Mitsuyasu, RMitsuya@mednet.ucla.edu
ACSR Mission
To provide high-quality HIV-associated malignancy specimens to qualified
investigators at little or no cost
ACSR Specimens• > 500,000 specimens and growing• Twenty different diagnosis codes (CA and controls)• Types of specimens
– Frozen tissues – PBMCs– Plasma– Body fluids (e.g., saliva, urine, CSF) – Formalin – fixed tissues
• Associated Clinical Data
West Coast CoastMid-Mid-RegionRegion
East East CoastCoast
ACSR Representation
“Collections” within the ACSR
• TMAs (NHL, KS)
• AMC studies
• WIHS Study
• HIV multi-site autopsies
• SF Gay men’s KS epidemiology study (Martin et al.)
• International specimens– Thailand HIV+ Plasma (vaccine study)
– Rwandan women (WIHS)
– Ugandan KS and natural history (Martin et. Al.)
ACS “Resource”
• Searchable on the Web – http://acsr.ucsf.edu
• Facilitate collaborations with investigators and specimen sources
• Procurement of requested specimens if not in the ACSR collection
Dr. Mike McGrath MMcGrath@php.ucsf.edu
Comprehensive Cancer Centers
Cancer Centers
Planning Centers
Cancer Centers
Dr. Hasnaa Shafikshafikh@mail.nih.gov
International Network for Cancer Treatment and Research
• The INCTR is a non for profit, non governmental organization dedicated to helping to build capacity for cancer treatment and research in countries with limited resources.
• Capacity building, Palliative care and educational programs• Disease interests: NH lymphoma, cervical cancer
Dr. Ian Magrath, PIhttp://www.inctr.org/
NCI/OHAM Cofunded Programs
MACS, Multicenter AIDS Cohort Study WIHS, The Women's Interagency HIV Study CFARs, Centers for AIDS Research IeDEA, International Epidemiologic Databases
to Evaluate AIDS AITRP, AIDS International Training
and Research Program
CFAR Map
Dr. Geraldina Dominguezdomingug@mail.nih.gov
• Australia• Cambodia• India• Indonesia• Japan• China• Malaysia• Singapore• Thailand
Region 5: Australia, India, Pakistan, Asia
• Burundi• Cameroon• Central African Republic• Congo, Dem. Rep. of (Zaire)• Congo, Republic of• Rwanda
Region 8: Central Africa
• Botswana• Malawi• Mozambique• South Africa• Zambia• Zimbabwe
Region 8: Southern Africa
• Kenya• Tanzania• Uganda
Region 8: East Africa
• Argentina• Brazil• Chile• Haiti• Honduras• Peru•Mexico
Region 2: Latin America & Caribbean
Region 1: North America Canada• United States
Region 8: West Africa
• Mali• Nigeria• Senegal
• Benin• Cote d'Ivoire• Gambia
NCI NICHD
Funding Opportunities for AIDS Malignancies
Research on Malignancies in the Context of HIV/AIDS (R01 and R21)
http://grants.nih.gov/grants/guide/pa-files/PA-07-454.html and
http://grants.nih.gov/grants/guide/pa-files/PA-07-455.html
Research on Non-AIDS Defining Cancers & AIDS-associated Malignancies
Tentative
Hepatocellular Carcinoma
PA-08-243 R01 (Research Grants)http://grants.nih.gov/grants/guide/pa-files/PA-08-243.html
PA-08-244 R21 (Exploratory/Developmental Grants) http://grants.nih.gov/grants/guide/pa-files/PA-08-244.html
• PAR-08-245 P01 (Program Project Grants) http://grants.nih.gov/grants/guide/pa-files/PAR-08-245.html
Capacity Building
RFA: Strengthening Capacity for HIV-Associated Malignancies in Africa
PI from a US institution and an African Institution
Will support training in all disciplines from basic to clinical research to lay the foundation for the African/US investigators to seek future independent research grants on AIDS-related cancers
International Conference on Malignancies in AIDS & Other Acquired Immunodeficiencies
12th ICMOI, April 26 & 27, 2010 Bethesda, MD, USA
For more Information: Contact: Dr. Rebecca Huppi, liddellr@exchange.nih.gov Ms. Denise Jenkins, Jenkinde@mail.nih.gov
HIV Cancer Resources
Office of HIV and AIDS Malignancy
(OHAM) WEB Site
http://oham.cancer.gov/
Enhance Collaborations