程序性细胞死亡蛋白1（PD-1）抑制剂疗法在晚期癌症合并HIV感染患者中的应用：一项来自中国的单中心研究。

Use of programmed cell death protein 1 (PD-1) inhibitor therapy in HIV-infected patients with advanced cancer: a single-center study from China.

作者信息

Wu Luling, Su Jie, Yang Junyang, Gu Ling, Zhang Renfang, Liu Li, Lu Hongzhou, Chen Jun

机构信息

Department of Infectious Diseases and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.

Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, China.

出版信息

Infect Agent Cancer. 2023 May 30;18(1):35. doi: 10.1186/s13027-023-00512-z.

DOI:10.1186/s13027-023-00512-z

PMID:37254144

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10228114/

Abstract

BACKGROUND

Anti-PD-1 antibodies have been approved for treating several cancer. However, data regarding the safety and efficacy of these agents in HIV-infected patients with cancer is lacking, because these patients are frequently omitted from clinical trials.

OBJECTIVES

The primary aim of our research is to assess the safety, activity, and long-term outcomes of PD-1 inhibitors in the treatment of HIV-infected patients with advanced cancer.

METHOD

We retrospectively analyzed data from HIV-infected patients with advanced cancers who were treated with PD-1 inhibitors at Shanghai Public Health Clinical Center, Shanghai, China.

RESULTS

Fifteen HIV-infected patients (all are men; asian; median age, 44) with cancer who were treated with chemotherapy and/or combined the other oncology treatments [along with combined antiretroviral therapy (cART)] prior to Sintilimab (12 out of 15) or Nivolumab (1 out of 11) or Camrelizumab (2 out of 11) injection were identified. Eight patients responded to treatment (disease control rate 53.3%), with 1 got partial response (PR) and 7 were stable. Most treatment-emergent adverse events (TEAEs) were grade 1 or 2 including anemia, leukopenia, hyperglycemia, granulocytopenia, and thrombocytopenia. Eight patients (53.3%) experienced treatment-related AEs (TRAEs) with grades 3/4including myelosuppression, infection, and neurological disorders. CD4 T cell count and plasma HIV RNA remained stable throughout the treatment.

CONCLUSIONS

When used in HIV-infected patients with advanced malignancies, PD-1 inhibitors tend to have favorable efficacy, manageable side effects, and no deteriorated impacts on plasma HIV-RNA and CD4 T cell count.

摘要

背景

抗程序性死亡蛋白1（PD-1）抗体已被批准用于治疗多种癌症。然而，关于这些药物在感染人类免疫缺陷病毒（HIV）的癌症患者中的安全性和有效性的数据尚缺乏，因为这些患者在临床试验中常常被排除在外。

目的

我们研究的主要目的是评估PD-1抑制剂治疗晚期HIV感染癌症患者的安全性、活性和长期疗效。

方法

我们回顾性分析了在中国上海公共卫生临床中心接受PD-1抑制剂治疗的晚期HIV感染癌症患者的数据。

结果

确定了15例接受过化疗和/或在注射信迪利单抗（15例中的12例）、纳武利尤单抗（11例中的1例）或卡瑞利珠单抗（11例中的2例）之前接受过其他肿瘤治疗[联合抗逆转录病毒疗法（cART）]的感染HIV的癌症患者（均为男性；亚洲人；中位年龄44岁）。8例患者对治疗有反应（疾病控制率53.3%），其中1例获得部分缓解（PR），7例病情稳定。大多数治疗期间出现的不良事件（TEAE）为1级或2级，包括贫血、白细胞减少、高血糖、粒细胞减少和血小板减少。8例患者（53.3%）发生3/4级与治疗相关的不良事件（TRAE），包括骨髓抑制、感染和神经障碍。在整个治疗过程中，CD4 T细胞计数和血浆HIV RNA保持稳定。