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David S. Ettinger, MD, FACP, FCCP
David S. Ettinger, MD, FACP, FCCP
Posted: Wednesday, November 23, 2022
During the 2022 Society for Immunotherapy of Cancer (SITC) Annual Meeting (Abstract 437), Talal El Zarif, MD, of Dana-Farber Cancer Institute, Boston, and colleagues evaluated the safety and efficacy of immune checkpoint inhibitors in the treatment of patients diagnosed with human immunodeficiency virus (HIV) and non–small cell lung cancer (NSCLC). Despite the need for larger prospective studies, the results of this matched cohort study demonstrated similar toxicity profiles for patients who were HIV-positive and -negative, supporting the use of immunotherapy for this patient population.
This retrospective study focused on 64 patients with HIV and 117 matched HIV-negative controls who were diagnosed with metastatic NSCLC and underwent immune checkpoint inhibitor therapy. Each patient with HIV was matched to one or two HIV-negative controls by sex, age, number of prior systemic therapy lines, class of immune checkpoint inhibitor, and use of concurrent chemotherapy.
The median patient age was 60 years, with most patients identifying as male (77%). Approximately 89% of participants received anti–PD-1 therapy, 61% had an immune checkpoint inhibitor as their first line of therapy, and 46% were administered concurrent chemotherapy. Of note, those identifying as Black or African American were more represented among the HIV-positive (42%) than the HIV-negative (23%) populations (P < .01).
At baseline, patients who were HIV-positive had a median CD4 cell count of 386 cells/mL, with 19 patients having an undetectable HIV viral load. Grade 3 immune-related adverse events affected 11% and 9% of HIV-positive and -negative cohorts, respectively; the overall response rate was similar between the groups (25% vs. 37%; P = .25). The difference in restricted mean survival time within 42 months between HIV-positive and HIV-negative individuals was 1.8 months for overall survival and 0.4 months for progression-free survival. Of note, both overall survival (41.7% vs. 42.9%) and progression-free survival (18.1% vs. 18.7%) rates were similar among patients who were HIV-positive and HIV-negative.
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