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Immunotherapy for Patients With NSCLC and HIV Infection

By: Cordi Craig
Posted: Tuesday, March 19, 2019

Immune checkpoint inhibitor therapy may offer similar benefits to patients infected with human immunodeficiency virus (HIV) as it has for those without the virus, according to a study published in JAMA Oncology. Michael R. Cook, MD, and Chul Kim, MD, MPH, of Georgetown University, Washington, DC, reported similar objective response rates among patients with and without HIV treated for non–small cell lung cancer (NSCLC). The study findings suggest that immune checkpoint inhibitor therapy may prove to be a safe and effective option for patients with HIV and advanced-stage cancer.

“There are signals in this analysis and other studies that suggest these new cancer drugs may restore an immune response against HIV in patients whose immune system is exhausted by its long fight with HIV,” stated Dr. Kim in an institutional press release.

The authors identified 73 patients who were being treated with immunotherapy for advanced-stage cancer in a systematic review and literature search. Patients received anti–PD-1 therapy (n = 62) , anti–CTLA-4 therapy (n = 6), anti–PD-1/CTLA-4 therapy (n = 4), and sequential ipilimumab and nivolumab therapy (n = 1).

Those with HIV infection did not experience more side effects than those without HIV infection. The objective response rates were 30%, 27%, and 63% for patients with NSCLC, melanoma, and Kaposi sarcoma, respectively. After treatment, HIV infection remained undetectable in 93% of patients (26 of 28) known to have undetectable viral load prior to treatment. In addition, CD4 cell counts increased following treatment among the 25 patients with pretreatment cell counts.

“We hope our finding will lead to increased study of checkpoint inhibitors in patients with HIV and cancer,” Dr. Kim concluded.

Disclosure: The study authors’ disclosure information may be found at jamanetwork.com.



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