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Use of programmed cell death protein 1 (PD-1) inhibitor therapy in HIV-infected patients with advanced cancer: a
Luling Wu1,2, Jie Su3, Junyang Yang1
1Department of Infectious Diseases and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
Background:
Anti-PD-1 antibodies have been approved for treating several cancer. However, data regarding the safety and efficacy of these agents in HIV-infected patients with cancer is lacking, because these patients are frequently omitted from clinical trials.
Objectives:
The primary aim of our research is to assess the safety, activity, and long-term outcomes of PD-1 inhibitors in the treatment of HIV-infected patients with advanced cancer.
Method:
We retrospectively analyzed data from HIV-infected patients with advanced cancers who were treated with PD-1 inhibitors at Shanghai Public Health Clinical Center, Shanghai, China.
Results:
Fifteen HIV-infected patients (all are men; asian; median age, 44) with cancer who were treated with chemotherapy and/or combined the other oncology treatments [along with combined antiretroviral therapy (cART)] prior to Sintilimab (12 out of 15) or Nivolumab (1 out of 11) or Camrelizumab (2 out of 11) injection were identified. Eight patients responded to treatment (disease control rate 53.3%), with 1 got partial response (PR) and 7 were stable. Most treatment-emergent adverse events (TEAEs) were grade 1 or 2 including anemia, leukopenia, hyperglycemia, granulocytopenia, and thrombocytopenia. Eight patients (53.3%) experienced treatment-related AEs (TRAEs) with grades 3/4including myelosuppression, infection, and neurological disorders. CD4+ T cell count and plasma HIV RNA remained stable throughout the treatment.
Conclusions:
When used in HIV-infected patients with advanced malignancies, PD-1 inhibitors tend to have favorable efficacy, manageable side effects, and no deteriorated impacts on plasma HIV-RNA and CD4+ T cell count.
Insights
This study shows that PD-1 inhibitors are effective and safe for HIV-infected patients with advanced cancers, with manageable side effects and stable HIV viral load and CD4 counts.
Area of Science:
- Oncology
- Immunotherapy
- Infectious Diseases (HIV)
Background:
- Anti-PD-1 antibodies are approved for cancer treatment, but data in HIV-infected patients is limited.
- HIV-infected patients are often excluded from clinical trials, creating a knowledge gap.
Purpose of the Study:
- To evaluate the safety, efficacy, and long-term outcomes of PD-1 inhibitors in advanced cancer patients with HIV.
- To assess the impact of PD-1 inhibitors on HIV viral load and CD4+ T cell counts.
Main Methods:
- Retrospective analysis of 15 HIV-infected patients with advanced cancer treated with PD-1 inhibitors.
- Data collected on treatment response, adverse events, and HIV disease markers.
Main Results:
- A disease control rate of 53.3% was observed, with 1 partial response and 7 stable disease cases.
- Most treatment-emergent adverse events were low-grade; 53.3% experienced grade 3/4 TRAEs, including myelosuppression and neurological disorders.
- CD4+ T cell counts and HIV RNA levels remained stable during treatment.
Conclusions:
- PD-1 inhibitors demonstrate favorable efficacy and manageable safety profiles in HIV-infected patients with advanced malignancies.
- Treatment with PD-1 inhibitors did not negatively impact HIV viral load or CD4+ T cell counts.
