Lymphoma Clinical Trial
Official title:
A Companion Protocol to Evaluate Anogenital Human Papillomavirus (HPV) Infection and Anogenital Squamous Intraepithelial Lesions (ASIL) in Subjects Participating in AMC Clinical Trials
RATIONALE: Diagnostic procedures, such as anal swab collection, digital rectal examination,
and anal endoscopy and biopsy, may help find and diagnose anal and genital human
papillomavirus infection and squamous intraepithelial lesions and help doctors plan better
treatment.
PURPOSE: This clinical trial is studying ways to detect anal and genital human papillomavirus
infection and squamous intraepithelial lesions in HIV-positive patients enrolled in an AIDS
cancer clinical trial.
OBJECTIVES:
Primary
- To determine if various pharmacotherapeutic agents investigated in primary AIDS
Malignancy Clinical Trials (AMC) for diseases other than human papillomavirus
(HPV)-associated neoplasia have any preliminary evidence of activity against anogenital
HPV infection or anogenital squamous intraepithelial lesions (ASIL) in HIV-positive
patients participating in these trials.
- To describe changes in the types of anal HPV present and the prevalence of ASIL in
patients treated on these studies.
- To evaluate cervical HPV infection and cervical/vulvovaginal disease in HIV-positive
women participating in these trials.
- To describe changes in cervical HPV infection and cervical/vulvovaginal disease in these
women after undergoing various study treatments.
OUTLINE: This is a multicenter study.
Patients undergo anal swab collection at baseline to obtain samples for anal cytology, anal
human papillomavirus (HPV) typing, and other HPV-related testing (e.g., HPV viral load).
Digital rectal examinations (DRE) are also performed as part of the baseline physical
examination. Female patients also undergo cervical swab collection for cervical HPV testing
and cytology, as well as colposcopy (if available) of the cervix and vulvovaginal region to
completely assess lower genital tract HPV-related lesions. At sites where high-resolution
anoscopy (HRA) is available, patients are encouraged, but not required, to have an HRA with
biopsy of any visualized lesions within 30 days of collection of the swabs.
After baseline assessments, patients undergo treatment with the investigative agent according
to the study protocol requirements. If study treatment continues beyond 6 months, additional
anal and cervical swabs are obtained for anal and cervical HPV and cytology along with DREs
every 6 months until completion of study treatment and at the final study visit. Patients may
also undergo additional HRA with biopsy and/or colposcopy of the lower genital tract with
biopsy (women only) at this time. Patients with an abnormal anal cytology or histology are
referred for HRA per local standard of care. If HRA is not available at the treatment site,
patients undergo a DRE, and those with an abnormal DRE are referred for evaluation by a
surgeon.
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