Abstract 511P
Background
Despite a higher incidence of HPV-related cancer in HIV-positive (HIV+) patients (pts), pivotal studies with curative chemoradiation (CRT) in anal cancer do not include this population. The impact of HIV infection remains unknown in this scenario. This study aimed to compare overall survival (OS) according to HIV status.
Methods
In this retrospective matched cohort study, we reviewed electronic medical records in Sao Paulo State Cancer Institute between 2010 and 2021 and selected available patients (pts) with anal cancer T1-4 N0-1 M0 by AJCCVIII. For each HIV+ pts, we selected one or two HIV- cases matched by age, stage (T, N), and ECOG. The primary endpoint was OS; estimated using Kaplan-Meir and compared with the log-rank test.
Results
Our final sample was 122 patients, 45 being HIV+. We included 2 HIV-:1 HIV+ (n=96) plus 1 HIV-:1 HIV+ (n=26) match. The median follow-up was 37 months (m). The majority of patients n=119, 98%, received concomitant CRT with curative intent and had ECOG 0/1, n=116, 95%. Stage III was seen in n=85 pts, 69% with T4 (n=41, 33%) or T3 tumors (n=36, 29%). Positive nodes were detected in 76 pts, 62%. No difference was observed in complete response (CR) at 6 months post QT/RDT, which was 68% in HIV+ vs. 63% in HIV- (p=0.6). Median RFS was not reached; 3yRFS rates was 60.7% in HIV+ vs. HIV- (HR 1.20, 95% CI 0.66 - 2.17, p=0.538). Median OS was not reached; 3yOS was 66.4% HIV+ vs. 72.2% in HIV- (HR 1.23, 95% CI 0.61 - 2.47, p=0.546). HIV+ pts presented significantly more hospital admission due to toxicity 29% (n=12/41) than HIV- 13% (n=10/74) (p=0.04).
Conclusions
HIV+ pts with anal carcinoma treated with CRT presented similar CR, RFS, and OS outcomes compared with HIV- pts. Optimal therapy should be attempted in the HIV+ population. More hospital admission due to toxicity occurs in the HIV+ group.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
C. Motta Venchiarutti Moniz.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.