Brief Report: Real-World Outcomes in Patients Living With Human Immunodeficiency Virus and Lung Cancer Treated With...

Lung cancer is the most common non-acquired immunodeficiency syndrome-defining cancer in people living with human immunodeficiency virus (PLWH). PLWH were initially excluded from clinical trials of immune checkpoint inhibitors (ICIs) because of safety and efficacy concerns; little is known about real-world rates of immune-related adverse events (irAEs) and outcomes in PLWH with lung cancer treated with ICIs.

Adults (age ≥18 y) diagnosed with lung cancer and treated with ICIs between 2015 and 2021 were identified from the Merative MarketScan database. Patients were stratified into the following two cohorts: PLWH and PLWoH (people living without human immunodeficiency virus). We evaluated rates of irAEs and estimated overall survival (OS) between groups with Kaplan-Meier survival analysis; survival function was calculated from ICI initiation to death or last follow-up. We used the log-rank test to assess statistical differences in survival between cohorts.

Of the 21,259 people with lung cancer treated with ICIs, 105 were identified as PLWH. There was no significant difference in median OS of PLWH versus PLWoH (343 versus 364 days, p = 0.62). PLWH experienced a similar rate of irAEs (59.1%) as PLWoH (58.8%). The most common irAEs in PLWH were neurologic (35.48%), endocrine (33.87%), renal (24.19%), and cardiac (24.19%), versus endocrine (47.69%), renal (28.80%), cutaneous (25.22%), and cardiac (24.39%) in PLWoH. Patients who experienced irAEs had significantly improved OS in both cohorts versus those without irAEs (both p < 0.0001).

We found similar rates of irAEs and OS in real-world populations of PLWH and PLWoH with lung cancer treated with ICIs. Further research is needed to identify predictors of toxicities.