# Optimizing Treatment of Prostate Cancer in Men living with HIV

> **NIH NIH R01** · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · 2024 · $669,206

## Abstract

SUMMARY
Cancer is a leading cause of morbidity and mortality among aging people with HIV (PWH) and prostate cancer
is now one of the most common cancers among PWH. Despite this, prostate cancer remains the least studied
tumor in terms of its natural history and clinical outcomes in the context of HIV. Our findings suggest that HIV
infection is associated with rapid carcinogenesis, increased adverse treatment events, and elevated mortality
risk. However, there are very limited data on the impact of HIV on treatment selection (versus active surveillance)
on key short- and long-term outcomes, including cancer control, quality of life, and mortality particularly for PWH
with clinically localized prostate cancer (the most commonly diagnosed stage). These include tradeoffs in toxicity
profiles and oncologic control among therapeutic modalities, as well as competing risks of death from non-cancer
causes. Quantifying the downstream harms and benefits of different management strategies for localized
prostate cancers is critical to aid decision-making, maximize treatment benefits, and reduce harms. Despite
compelling need, treatment of localized prostate cancer has never been investigated in the context of HIV in
clinical trials, and extrapolating results from clinical trials in HIV uninfected persons is inappropriate due to
differences in treatment complications and tolerability. Furthermore, unique HIV-related factors may substantially
alter prostate cancer natural history, comorbidities, functional status, risk of second primary cancers, life
expectancy, and quality of life. This project will determine the role of HIV on localized prostate cancer natural
history and outcomes. We will synthesize a disease simulation that will be used to perform comparative
assessment of common treatment pathways to guide treatment decision-making. Our Specific Aims are: (1) To
evaluate the impact of immune dysfunction and specific ART regimens on a) active surveillance (AS) for low-risk
disease, and definitive treatment for intermediate- and high-risk disease and b) outcomes and adverse treatment
events for all stages of prostate cancer among PWH; (2) To create and validate a microsimulation model (HIv
Prostate Treatment [HIPR-T]) of prostate cancer natural history and treatment outcomes for localized prostate
cancer in PWH; and (3) To use the HIPR-T model to compare the benefits vs harms of optimized AS and
definitive treatment for localized prostate cancer over the lifetime of PWH. To achieve these aims, we will use
data from large, representative HIV/cancer cohorts (>3,000 PWH prostate cancer survivors) and a validated HIV
natural history simulation framework. We will synthesize and validate a novel prostate cancer-HIV simulation
model capturing AS, treatment initiation and definitive therapy outcomes. Then, we will use the enhanced model
to assess the optimal management of PWH with localized prostate cancer that will maximize survival and quality
of life. The finding...

## Key facts

- **NIH application ID:** 10895472
- **Project number:** 5R01CA285342-02
- **Recipient organization:** ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
- **Principal Investigator:** Elizabeth Y. Chiao
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $669,206
- **Award type:** 5
- **Project period:** 2023-08-01 → 2028-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10895472

## Citation

> US National Institutes of Health, RePORTER application 10895472, Optimizing Treatment of Prostate Cancer in Men living with HIV (5R01CA285342-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10895472. Licensed CC0.

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