Gita Suneja, MD
Erin Reid, MD
Robert W. Carlson, MD
The National Comprehensive Cancer Network® (NCCN®) has created a new resource for patients living with human immunodeficiency virus (HIV) who develop acquired immune deficiency syndrome (AIDS)-related Kaposi sarcoma. This newly released NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) brings the total library to 68 NCCN Guidelines®. Additional NCCN Guidelines devoted to overall cancer care for people living with HIV will be released in early 2018.
“These new NCCN Guidelines for AIDS-Related Kaposi Sarcoma are a first step to ensuring that people living with HIV receive appropriate and equitable cancer treatment,” said Gita Suneja, MD, of the Duke Cancer Institute, Co-Chair of the NCCN Guidelines Panel for AIDS-Related Kaposi Sarcoma. “NCCN recognizes the urgent need for cancer management guidelines in this special population of patients. The Guidelines Panel is comprised of experts from NCCN Member Institutions across the United States, including oncologists, HIV specialists, pharmacists, and patient advocates. In compiling these Guidelines, we learned a tremendous amount from each other and hope this will benefit clinicians and, most importantly, patients living with HIV.”
The incidence of AIDS-related Kaposi sarcoma in people living with HIV has fallen dramatically in the United States in recent years, thanks to advancements in HIV treatments. It is considered an AIDS-defining illness and was famously featured in the movie Philadelphia. The disease can be limited to skin lesions, which tend to respond well to treatment, but when more advanced, it can be difficult to treat.
There are also other types of Kaposi sarcoma that affect HIV-negative individuals; treatment recommendations for those cancers will be included in future updates of these guidelines.
Gap in Guidance
NCCN Guidelines Panel Co-Chair Erin Reid, MD, of UC San Diego Moores Cancer Center, further explained, “The NCCN Guidelines for AIDS-Related Kaposi Sarcoma fill an important gap in guidance for care of this rare but important malignancy. Although incidences have decreased, the disease remains one of the most common cancers occurring in persons living with HIV—not only in patients with newly diagnosed HIV infection or inadequate suppression of HIV, but also in people who otherwise appear to have maximum viral suppression and ‘normal’ CD4-positive T-cell counts.”
NCCN made the decision to create a panel devoted to AIDS-related Kaposi sarcoma while working with the African Cancer Coalition, American Cancer Society, and Clinton Health Access Initiative to create the NCCN Harmonized Guidelines™ for Sub-Saharan Africa.
“While the medical community has made monumental strides toward reducing the impact of HIV and AIDS, there are still more than a million people living with HIV in the United States today,” explained Robert W. Carlson, MD, Chief Executive Officer of NCCN. “That patient population is then diagnosed with cancer at a 50% higher rate than people in the general population. Our work with the African Cancer Coalition began as a way to help them with some of the particular health issues in their home countries. In the end, it also resulted in us finding new ways to expand our library of Guidelines for patients here at home.”
The NCCN Guidelines for AIDS-Related Kaposi Sarcoma are available free of charge for noncommercial use online at NCCN.org. They can also be viewed via the Virtual Library of NCCN Guidelines mobile app for smartphones and tablets. ■
Cancer care in Sub-Saharan Africa, as in other low-resource settings, can be a challenge: The right medications and equipment may be in short supply, maintaining equipment can be a problem, basic chemotherapy drugs may be unaffordable, and patients may not see doctors until the cancer is advanced....