The future of research: HIV cure and cancer

Sunday, September 24, 2017

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This a lightly edited version of a collaboration between the International AIDS Society (IAS) and Geneviève Almouzni, director of the Institut Curie Research Centre and CNRS research director, of her sharing her key takeaways from the recently held IAS HIV Cure and Cancer Forum, at the Institut Curie.

 

AS the second leading cause of death globally, cancer is a serious global health problem, accounting for 8.8 million deaths in 2015 alone.

Across the world, scientists are collaborating to develop effective treatments and tools to combat this disease and save lives, making remarkable advances.

In the long search for innovative ways to achieve a cure or remission for HIV, a rigorous analysis of these approaches and interdisciplinary collaboration between the two fields could be a game-changer for researchers and scientists working towards a cure for HIV. In fact, efforts are already under way to evaluate various cancer drugs to assess their capacity to reduce viral persistence.

To explore the cross link between these two fields, the International AIDS Society (IAS) hosted a forum, the IAS HIV Cure and Cancer Forum, at the Institut Curie, immediately prior to the 9th IAS Conference on HIV Science in July 2017. The aim of this forum was to promote interactions between the HIV cure and cancer fields, and to share knowledge and accelerate research on virology, immunology and epigenetics in HIV and cancer.

Today, it is worth reviewing the key outcomes from the recent forum, with an eye towards galvanising synergistic, results-oriented collaboration with these disciplines.

Although HIV, a viral infection, is distinct from cancer — a constellation of diseases linked with abnormal cell growth — there are a number of synergies between the HIV and cancer research fields.

Immunotherapy, a growing focus for HIV cure research, builds in part on learning generated from the cancer field. In both HIV cure and cancer research efforts, a number of parallel obstacles are encountered, including the persistence of viruses and certain types of cancer, immune system functioning, treatment resistance, and “residual disease”, when the disease itself is undetectable but a few cells are able to reactivate and cause a relapse.

There is also epidemiological overlap between HIV and cancer. People living with HIV are several thousand times more likely than uninfected people to be diagnosed with Kaposi's sarcoma, at least 70 times more likely to be diagnosed with non-Hodgkin lymphoma, and, among women, at least five times more likely to be diagnosed with cervical cancer.

The convergence of the cancer and HIV cure agendas underscores the potential value of interdisciplinary collaboration.

The forum emphasised the urgent need for HIV and cancer researchers to combine their expertise to advance research in therapeutic strategies. To develop therapeutic and curative regimens, both for the immune system and for infected or malignant cells, is to understand the destiny and plasticity of cells. Recent progress in characterising the epigenetic parameters that define cell identity and the ability to reprogramme these choices, offer new research opportunities to explore.

Additionally, the two disciplines must continue working together to develop and apply novel technologies in a post-genome era. Where possible, the two disciplines should share knowledge to accelerate research, overcome obstacles, and identify new opportunities for collaboration. As one example, proven methods for counteracting side effects of antiretroviral therapy might aid in minimising side effects of immunotherapies in cancer.

As the HIV cure field could greatly benefit from the scientific advances in cancer research, greater collaboration could also help the cancer field emulate an amazing strength and pillar of the AIDS response – patient engagement and advocacy. HIV activism played a pivotal role in combating indifference and accelerating access to new treatments. The HIV cure field provides an advocacy model to other disciplines, such as cancer, to mobilise authorities on a global scale to advocate for focused research, screening, and reduced treatment costs.

Both the HIV and cancer fields have benefited from a granular, disease-specific focus. But the forum demonstrated how collaboration and mutual learning between these fields could also prove equally beneficial.

As a researcher, I am now even more convinced that the collaborative interaction between HIV and cancer research could be the future, and I look forward to working with my fellow scientists to continue this exploration together.

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