Innovative HIV Protocols Underway at Roswell Park

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

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

Photodynamic therapy (PDT) was pioneered at Roswell Park, Dr. Bernsteinsaid in his presentation at the Roswell Park-sponsored conference "HIV,Cancer & the Family." PDT combines tissue-penetrating red laserlight 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 thesensitized cancer cells, and a tumor-destructive oxygen is released. Protocolsat the Institute are studying the efficacy of this treatment in Kaposi'ssarcoma, and early results show decreasing lesions with excellent palliativeand cosmetic results.

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

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

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

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