Anti-PD-1/PD-L1 immunotherapy in patients with solid organ transplant, HIV or hepatitis B/C infection

Area of Science:

• Oncology
• Immunotherapy
• Infectious Diseases

Background:

• Anti-programmed cell death protein 1/programmed death ligand 1 (PD-1/PD-L1) immunotherapy is a standard cancer treatment.
• Clinical trials have historically excluded patients with solid organ transplant, HIV, or hepatitis B/C infections.
• This study investigates the safety and efficacy of PD-1/PD-L1 inhibitors in these underrepresented patient groups.

Purpose of the Study:

• To evaluate the safety outcomes of PD-1/PD-L1 immunotherapy in patients with solid organ transplants, HIV, or hepatitis B/C infections.
• To assess treatment response rates in these specific patient populations.
• To identify any unexpected toxicities or changes in viral load associated with immunotherapy.

Main Methods:

• A multicentre retrospective study included 46 patients with advanced cancer.
• Patients had either solid organ transplants, HIV infection, or hepatitis B/C infection.
• Demographic, tumor, treatment, toxicity, and outcome data were collected and analyzed.

Main Results:

• Among 6 solid organ transplant patients, 2 experienced graft rejection (1 fatal), and 2 had partial responses.
• In 12 HIV-infected patients, 4 achieved responses.
• 14 patients with hepatitis B and 14 with hepatitis C each showed 3 responses, with no unexpected toxicity or increased viral load.

Conclusions:

• PD-1/PD-L1 immunotherapy can be safely administered to patients with HIV or hepatitis B/C infections, showing potential for treatment response without increased toxicity.
• The risk of graft rejection in solid organ transplant recipients necessitates careful consideration of PD-1/PD-L1 immunotherapy, despite potential treatment benefits.