Safety and Efficacy of PD-1 Inhibitors Among HIV-Positive Patients With Non-Small Cell Lung Cancer

• Published in: Journal of thoracic oncology Vol. 13; no. 7; p. 1037
• Main Authors: Ostios-Garcia, Lorena, Faig, Jennifer, Leonardi, Giulia C, Adeni, Anika E, Subegdjo, Safiya J, Lydon, Christine A, Rangachari, Deepa, Huberman, Mark S, Sehgal, Kartik, Shea, Meghan, VanderLaan, Paul A, Cheng, Matthew P, Marty, Francisco M, Hammond, Sarah P, Costa, Daniel B, Awad, Mark M
• Format: Journal Article
• Language: English
• Published: United States 01-07-2018
• Subjects: Adult; Antibodies, Monoclonal, Humanized - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; B7-H1 Antigen - antagonists & inhibitors; Carcinoma, Non-Small-Cell Lung - complications; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - virology; Female; Follow-Up Studies; HIV - drug effects; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - virology; Humans; Lung Neoplasms - complications; Lung Neoplasms - drug therapy; Lung Neoplasms - virology; Male; Middle Aged; Nivolumab - administration & dosage; Prognosis; Retrospective Studies; Survival Rate; Pembrolizumab; HIV; Immunotherapy; Lung cancer; Nivolumab; PD-L1; PD-1
• ISSN: 1556-1380
• DOI: 10.1016/j.jtho.2018.03.031

Despite widespread administration of programmed death receptor 1 (PD-1) pathway inhibitors among individuals with NSCLC, little is known about the safety and activity of these agents among human immunodeficiency virus (HIV) - infected patients since this population has largely been excluded from immunotherapy clinical trials.
Here, we describe seven patients with metastatic NSCLC and HIV infection who were treated with PD-1 inhibitors nivolumab (two cases) or pembrolizumab (five cases with three in the first-line setting).
Partial responses to immune checkpoint inhibitors were observed in three of seven cases. Among four patients with a programmed death ligand-1 tumor proportion score ≥50%, three partial responses were observed. All patients received antiretroviral therapy while on anti-PD-1 treatment. None of the patients experienced grade 3 or 4 immune-related adverse events or immune reconstitution inflammatory syndrome, and none required PD-1 inhibitor dose interruption or discontinuation due to toxicity.
Nivolumab and pembrolizumab can be safe and effective among patients with NSCLC and HIV. Larger studies will be needed to determine the overall safety and efficacy of immune checkpoint inhibitors among cancer patients with HIV.