Modern medicine, often a near miracle, creates more challenges to solve. For instance, the adoption worldwide of antiretroviral therapies to suppress the HIV virus has helped tens of millions of people with HIV live healthier, longer lives. However, with this extension of life comes increased risk for cancer. Thankfully, for a quarter of a century now, the AIDS Malignancy Consortium (AMC) spearheads national and international initiative to prevent and treat HIV-related cancers. Now the National Cancer Institute (NCI) has granted $111 million over five years to Montefiore Health System and Albert Einstein College of Medicine to lead this research consortium and intensify the battle against HIV-related cancer.
The “AIDS Malignancy Consortium” grant is funded by the National Cancer institute, part of the National Institutes of Health (2UM1CA121947). New York City-based Montefiore Health System and Albert Einstein College of Medicine came together to issue a press release and inform the world about the grant to take this challenge on.
Approximately 38 million people are infected with HIV, including 1.2 million in the U.S. People living with HIV have an increased risk of developing cancer compared with the general population and are more likely to die of cancer, interrupting otherwise healthy lives. This is due to a variety of causes, including long-term inflammation and an overtaxed immune system. In addition, HIV infections are concentrated in marginalized communities in the U.S., primarily among people of color, who make up approximately 70% of new infections.
In response to these pressing challenges, New York City-based Montefiore developed an HIV Oncology Serve, directed by Luca Paoluzzi, MD, a medical oncologist there. He is also an assistant professor of medicine at Einstein, and the AMC Principal Investigator at Montefiore and Einstein. This new service, backed by the NCI, brings together both Montefiore and Einstein’s experience in patient care and research.
AMC has emerged as the only organization 100 percent dedicated to address cancer in the HIV population. Joseph Sparano, MD, Principal Investigator for the NCI grant, elaborated on the importance of this organization for those with HIV combating cancer offering “AMC is the only organization worldwide solely dedicated to the study, treatment, and prevention of cancer in this group of people. Montefiore and Einstein are perfectly positioned to lead this organization and steer research advances.”
It Takes Collaboration
The health centers aren’t alone. The team has already been in close collaboration with another National Institutes of Health (NIH)-funded group in New York. Principal Investigator Dr. Sparano in conjunction with Harris Goldstein, MD, associate dean for scientific resources and director of the NIH-funded Einstein-Rockefeller-CUNY Center for AIDS Research (CFAR), has formed a scientific working group focused on cancer and HIV that will guide the direction of future collaborative research at the CFAR and AMC. This group will be co-chaired by Dr. Sparano and Howard Stickler, MD, professor and chief of epidemiology in the department of epidemiology & population health at Einstein and Montefiore. Collectively they’ll identify and prioritize areas of highest need, evaluate emerging research and design new clinical trials to be conducted at dozens of locations at Montefiore and around the world.
The AMC Trial Site Network
The AMC oversees a network of 42 clinical trial sites in the United States, Africa, and Latin America, as well as translational scientists who support its clinical trials. It also runs a career enhancement program to ensure that the next generation of leaders receive resources and support. In addition, the AMC actively engages with people living with HIV and cancer throughout the world so the consortium can identify and address the needs of this community with their input.
AMC was established back in 1995 and in 25 years has initiated over 100 clinical trials, surveys, and laboratory studies involving approximately 8,700 individuals. The results from this type of research contribute to not only the strengthening of international practice guidelines, including treatment for Kaposi sarcoma and lymphoma, but also advanced prevention and management of human papillomavirus (HPV)-associated cancers. Additionally, the group’s research outcomes and learnings have led to the use of precision therapeutics and immunotherapy for people living with HIV who receive antiretroviral therapy.
Use of Funds
Dr. Sparano knows there is much work to do to continue the positive impacts associated with the last years. In the recent joint press release, Sparano conveyed, “During this next phase, we will build on these successes, developing and leading additional clinical trials designed to address the most critical needs of people with HIV and cancer, precancerous disease, and individuals at high risk for cancer—most importantly, completing the ANCHOR trial.”
The ANCHOR Study
The ANCHOR Study, which stands for Anal Cancer HSIL Outcomes Research, focuses on the prevention and treatment of anal cancer, which is caused by the human papilloma virus (HPV). The virus causes changes in the skin near the anus, called “high grade squamous intraepithelial lesions,” or HSIL, commented Dr. Sparano. Most HSIL go away on their own, but some become cancer and spread to other parts of the body.
Dr. Rebecca Levine, MD, assistant professor of surgery at Einstein, a surgical oncologist at Montefiore, and the ANCHOR principal investigator at Einstein and Montefiore, commented, “The aim of the study is to establish best practices for the prevention and treatment of anal cancer. We expect the results of this study will have an enormous impact on clinical care.”
Joseph Sparano, MD, associate chair for clinical research, department of oncology at Montefiore, associate director for clinical research at Albert Einstein Cancer Center, Principal Investigator for the NCI grant.
Rebecca Levine, MD, assistant professor of surgery at Einstein, a surgical oncologist at Montefiore, and the ANCHOR principal investigator at Einstein and Montefiore