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Innovative HIV Protocols Underway at Roswell Park

Innovative HIV Protocols Underway at Roswell Park

BUFFALO, NY--Researchers at Roswell Park Cancer Institute are recruiting patients for enrollment in 19 different protocols testing unique treatments for HIV-infected individuals. The goal of these protocols is to preserve or enhance the fragile immune system while treating and preventing malignancy.

"We are involved in several new protocols that we hope will improve the outcome for HIV-infected patients," said Zale P. Bernstein, MD, director of The Center for HIV-Related Malignancies at Roswell Park. "Some are new, such as photodynamic therapy. We are also developing regimens that allow for prolonged restitution of the immune system in this population of patients using interleukin-2 (IL-2)."

Photodynamic therapy (PDT) was pioneered at Roswell Park, Dr. Bernstein said in his presentation at the Roswell Park-sponsored conference "HIV, Cancer & the Family." PDT combines tissue-penetrating red laser light and a non-toxic, light-sensitive chemical (the photosensitizer) that, when injected into the body, remains in tumor tissue.

Efficiently delivered through fiberop-tics, the red light strikes the sensitized cancer cells, and a tumor-destructive oxygen is released. Protocols at the Institute are studying the efficacy of this treatment in Kaposi's sarcoma, and early results show decreasing lesions with excellent palliative and cosmetic results.

A new study involving GM-CSF is in the early phases. The daily, subcutaneous injection of GM-CSF appears to abrogate the immune suppression engendered by HIV. "We believe that the daily use of this substance will prevent the development of opportunistic infection and malignancy in this group of patients," Dr. Bernstein commented.

Research suggests that utilizing anti-neoplasm and antiretrovirus agents in combination will destroy and prevent regeneration of HIV. A current protocol combines hydroxyurea (Hydrea), a DNA inhibitor, and didanosine (ddI, Videx), a reverse transcriptase inhibitor. Together they act synergistically and appear to be well tolerated, he said.

Phase III trials of IL-2 are examining the effects of low daily maintenance doses, rather than the large ones tested in early studies. "This IL-2 treatment appears successful; in over 40 months we have had no opportunistic infections," Dr. Bernstein said.

Physicians interested in enrolling patients in any of these studies may contact The Center for HIV-Related Malignancies at 1-800-685-6825, ext. 8884.

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