Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.
Division of Hematology/Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
J Thorac Oncol. 2018 Jul;13(7):1037-1042. doi: 10.1016/j.jtho.2018.03.031. Epub 2018 Apr 6.
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.
尽管程序性死亡受体 1（PD-1）通路抑制剂已在非小细胞肺癌（NSCLC）患者中广泛应用，但由于该人群已基本被排除在免疫治疗临床试验之外，因此对于 HIV 感染患者中这些药物的安全性和疗效知之甚少。
在此，我们描述了 7 例患有转移性 NSCLC 和 HIV 感染的患者，他们接受了 PD-1 抑制剂纳武单抗（2 例）或帕博利珠单抗（5 例，其中 3 例一线治疗）治疗。
在 7 例患者中，有 3 例对免疫检查点抑制剂有部分反应。在 4 例程序性死亡配体-1 肿瘤比例评分≥50%的患者中，观察到 3 例部分反应。所有患者在接受抗 PD-1 治疗时均接受了抗逆转录病毒治疗。没有患者出现 3 级或 4 级免疫相关不良事件或免疫重建炎症综合征，也没有患者因毒性而需要中断或停止 PD-1 抑制剂治疗。
纳武单抗和帕博利珠单抗在 NSCLC 和 HIV 患者中是安全有效的。需要更大规模的研究来确定免疫检查点抑制剂在 HIV 癌症患者中的总体安全性和疗效。
