Real-world management of ovarian cancer in women living with HIV: treatment exposure, immune monitoring, and care barriers in a five-case series
- 1Shenzhen Third People’s Hospital , , ,
- 2South China Hospital, Medical School, Shenzhen University , , ,
- 3Shenzhen University General Hospital , , ,
Abstract
Background: With improved survival among people living with HIV (PLWH), non-AIDS-defining cancers have become increasingly prominent. Women living with HIV (WLWH) remain underrepresented in ovarian cancer trials, leaving limited evidence on the tolerability of standard therapies, including chemotherapy, anti-VEGF agents, and PARP inhibitors. These patients also face unique care barriers beyond biological uncertainties.
Methods: This retrospective review included five WLWH diagnosed with ovarian cancer (June 2022–March 2024). Three received anticancer treatment; one refused chemotherapy and was lost to follow-up; one had biopsy only. We collected data on demographics, HIV history, tumor characteristics, treatment exposure, adverse events (CTCAE v5.0), CD4 ⁺ /CD8 ⁺ counts, and HIV RNA, focusing safety and immune analyses on the three treated patients.
Results: Median age was 51 years; four had stage III–IV disease. No treatment-related deaths, persistent HIV rebound, or AIDS-defining events occurred. During first-line paclitaxel/carboplatin, one patient developed grade 3 neutropenia managed with G-CSF, but later developed significant thrombocytopenia on niraparib requiring dose reduction and hospitalization. Among two patients receiving bevacizumab, CD4 ⁺ patterns diverged: one showed a transient decline (387 to 259 cells/μL) with concurrent nedaplatin; another maintained stable counts (150 to 200 cells/μL). One patient had transient, self-limited HIV RNA elevation concurrent with disease progression, which resolved spontaneously.
Conclusion: This series provides real-world observations that platinum-based and targeted therapies may be delivered to selected WLWH with close monitoring. The heterogeneous CD4 ⁺ responses highlight the need for individualized immune surveillance rather than attributing changes to any single agent. Integrated oncologic-HIV care and attention to socioeconomic barriers remain critical for this underrepresented population.
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BibTeX
@article{zhang2026realworld,
title = {{Real-world management of ovarian cancer in women living with HIV: treatment exposure, immune monitoring, and care barriers in a five-case series}},
author = {Yang Zhang and Fuxiang Wang and Mingchuan Guo and Jianyu Wan and Huiyan Liao and Ting Mao and Lu Cui and Wenming Cao and Yutao Gao},
journal = {Frontiers in oncology},
year = {2026},
month = sep,
doi = {10.3389/fonc.2026.1942370},
url = {https://europepmc.org/article/PMC/PMC13661414},
note = {CC BY},
}
RIS
TY - JOUR
TI - Real-world management of ovarian cancer in women living with HIV: treatment exposure, immune monitoring, and care barriers in a five-case series
AU - Yang Zhang
AU - Fuxiang Wang
AU - Mingchuan Guo
AU - Jianyu Wan
AU - Huiyan Liao
AU - Ting Mao
AU - Lu Cui
AU - Wenming Cao
AU - Yutao Gao
PY - 2026
DA - 2026/09/30
JO - Frontiers in oncology
DO - 10.3389/fonc.2026.1942370
UR - https://europepmc.org/article/PMC/PMC13661414
AB - Background: With improved survival among people living with HIV (PLWH), non-AIDS-defining cancers have become increasingly prominent. Women living with HIV (WLWH) remain underrepresented in ovarian cancer trials, leaving limited evidence on the tolerability of standard therapies, including chemotherapy, anti-VEGF agents, and PARP inhibitors. These patients also face unique care barriers beyond biological uncertainties. Methods: This retrospective review included five WLWH diagnosed with ovarian cancer (June 2022–March 2024). Three received anticancer treatment; one refused chemotherapy and was lost to follow-up; one had biopsy only. We collected data on demographics, HIV history, tumor characteristics, treatment exposure, adverse events (CTCAE v5.0), CD4 ⁺ /CD8 ⁺ counts, and HIV RNA, focusing safety and immune analyses on the three treated patients. Results: Median age was 51 years; four had stage III–IV disease. No treatment-related deaths, persistent HIV rebound, or AIDS-defining events occurred. During first-line paclitaxel/carboplatin, one patient developed grade 3 neutropenia managed with G-CSF, but later developed significant thrombocytopenia on niraparib requiring dose reduction and hospitalization. Among two patients receiving bevacizumab, CD4 ⁺ patterns diverged: one showed a transient decline (387 to 259 cells/μL) with concurrent nedaplatin; another maintained stable counts (150 to 200 cells/μL). One patient had transient, self-limited HIV RNA elevation concurrent with disease progression, which resolved spontaneously. Conclusion: This series provides real-world observations that platinum-based and targeted therapies may be delivered to selected WLWH with close monitoring. The heterogeneous CD4 ⁺ responses highlight the need for individualized immune surveillance rather than attributing changes to any single agent. Integrated oncologic-HIV care and attention to socioeconomic barriers remain critical for this underrepresented population.
SN - 2234-943X
ER -