Jean-Philippe Spano1, Marianne Veyri2, Aurélien Gobert3, Amélie Guihot4, Philippe Perré5, Mallorie Kerjouan6, Solenn Brosseau7, Nicolas Cloarec8, Henri Montaudié9, Carole Helissey10, Thomas Flament11, Valérie Gounant7, Armelle Lavolé12, Isabelle Poizot-Martin13, Christine Katlama14. 1. Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, équipe Theravir, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Oncologie médicale. 2. AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Oncologie médicale, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, équipe Theravir. 3. AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Oncologie médicale, Sorbonne Université. 4. Sorbonne Université, INSERM U1135, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, Département d'Immunologie, Paris. 5. Département de Maladies infectieuses, CHD Vendée, La Roche sur Yon. 6. Département de Pneumologie, CHU Pontchaillou, Rennes. 7. Département d'Oncologie thoracique, Hôpital Bichat, Paris. 8. Départment d'Hématologie Clinique et d'Oncologie médicale, Hôpital d'Avignon. 9. Département de Dermatologie, Hôpital de l'Archet, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice. 10. Unité de Recherche Clinique, Oncologie médicale, HIA Bégin, F-94160 Saint-Mandé. 11. Service de Pneumologie, CHU de Tours. 12. Sorbonne Université, GRC n°04, Theranoscan, AP-HP, Service de Pneumologie, Hôpital Tenon, Paris. 13. Aix Marseille Univ, APHM, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Hôpital Sainte- Marguerite, Service d'Immuno-hématologie clinique, Marseille. 14. Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, équipe Theravir, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Maladies Infectieuses et Tropicales, Paris, France.
Abstract
OBJECTIVE: To report efficacy and tolerance of nivolumab or pembrolizumab, PD-1 inhibitors, in people living with HIV (PLWHIV) and cancer. DESIGN: Series of PLWHIV cancer patients treated with anti-PD1 agents in real-life clinical practice. METHODS: From May 2014 to January 2019, 575 HIV-infected patients have been discussed in the French CANCERVIH national multidisciplinary board and included in the network database. Twenty-three patients were treated with immune checkpoint inhibitors in daily practice. We report the demographic characteristics, CD4 T-cell counts, HIV viral loads, safety and efficacy data of these 23 PLWHIV treated in routine practice with nivolumab or pembrolizumab for nonsmall cell lung cancer (n = 21), melanoma (n = 1) and head and neck cancer (n = 1) retrospectively collected from the database CANCERVIH network. The median CD4 T-cell count at treatment initiation was 370 cells/μl (IQR: 125-1485). HIV viral load was undetectable in all patients. RESULTS: As of 29 April 2019, with a median follow-up of 10.8 months (2.0-27.7), the median number of injections was 6 (IQR: 4-18). Only two grade 3 adverse reactions were reported (no toxic deaths or immune-related deaths). Among the 23 patients, a partial response was observed in five patients (22%), a stabilization for five (22%) and a progression in 13 (57%). Only one patient experienced a positive HIV viral load, but this occurred following ART interruption. CONCLUSION: Treatment with PD-1 inhibitors seems to have an efficacy signal and be well tolerated in PLWHIV, including impact on CD4 lymphocyte count and HIV load, that should be monitored during treatment course (regarding real-life experience).
OBJECTIVE: To report efficacy and tolerance of nivolumab or pembrolizumab, PD-1 inhibitors, in people living with HIV (PLWHIV) and cancer. DESIGN: Series of PLWHIV cancerpatients treated with anti-PD1 agents in real-life clinical practice. METHODS: From May 2014 to January 2019, 575 HIV-infectedpatients have been discussed in the French CANCERVIH national multidisciplinary board and included in the network database. Twenty-three patients were treated with immune checkpoint inhibitors in daily practice. We report the demographic characteristics, CD4 T-cell counts, HIV viral loads, safety and efficacy data of these 23 PLWHIV treated in routine practice with nivolumab or pembrolizumab for nonsmall cell lung cancer (n = 21), melanoma (n = 1) and head and neck cancer (n = 1) retrospectively collected from the database CANCERVIH network. The median CD4 T-cell count at treatment initiation was 370 cells/μl (IQR: 125-1485). HIV viral load was undetectable in all patients. RESULTS: As of 29 April 2019, with a median follow-up of 10.8 months (2.0-27.7), the median number of injections was 6 (IQR: 4-18). Only two grade 3 adverse reactions were reported (no toxic deaths or immune-related deaths). Among the 23 patients, a partial response was observed in five patients (22%), a stabilization for five (22%) and a progression in 13 (57%). Only one patient experienced a positive HIV viral load, but this occurred following ART interruption. CONCLUSION: Treatment with PD-1 inhibitors seems to have an efficacy signal and be well tolerated in PLWHIV, including impact on CD4 lymphocyte count and HIV load, that should be monitored during treatment course (regarding real-life experience).
Authors: Blake J Rust; Leslie S Kean; Lucrezia Colonna; Katherine E Brandenstein; Nikhita H Poole; Willimark Obenza; Mark R Enstrom; Colby R Maldini; Gavin I Ellis; Christine M Fennessey; Meei-Li Huang; Brandon F Keele; Keith R Jerome; James L Riley; Hans-Peter Kiem; Christopher W Peterson Journal: Blood Date: 2020-10-08 Impact factor: 22.113
Authors: Mitchell S von Itzstein; Amrit S Gonugunta; Helen G Mayo; John D Minna; David E Gerber Journal: Cancer J Date: 2020 Nov/Dec Impact factor: 2.074
Authors: Maria Gonzalez-Cao; Teresa Puertolas; Mar Riveiro; Eva Muñoz-Couselo; Carolina Ortiz; Roger Paredes; Daniel Podzamczer; Jose Luis Manzano; Jose Molto; Boris Revollo; Cristina Carrera; Lourdes Mateu; Sara Fancelli; Enrique Espinosa; Bonaventura Clotet; Javier Martinez-Picado; Pablo Cerezuela; Ainara Soria; Ivan Marquez; Mario Mandala; Alfonso Berrocal Journal: J Immunother Cancer Date: 2021-03 Impact factor: 13.751