Kathryn Lurain1, Ramya Ramaswami1, Robert Yarchoan1, Thomas S Uldrick2,3,4,5. 1. HIV & AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA. 2. Division of Global Oncology, Department of Medicine, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. tuldrick@fredhutch.org. 3. Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, USA. tuldrick@fredhutch.org. 4. Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, USA. tuldrick@fredhutch.org. 5. Medical Oncology Division, University of Washington, 1100 Fairview Avenue North, Mail Stop M1-B140, Seattle, USA. tuldrick@fredhutch.org.
Abstract
PURPOSE OF REVIEW: Immune checkpoint inhibitors targeting the programmed cell death-1 (PD-1) pathway are a class of anti-cancer immunotherapy agents changing treatment paradigms of many cancers that occur at higher rates in people living with HIV (PLWH) than in the general population. However, PLWH have been excluded from most of the initial clinical trials with these agents. RECENT FINDINGS: Two recent prospective studies of anti-PD-1 agents, along with observational studies and a meta-analysis, have demonstrated acceptable safety in PLWH. Preliminary evidence indicates activity in a range of tumors and across CD4+ T cell counts. Safety and preliminary activity data suggest monoclonal antibodies targeting PD-1 or its ligand, PD-L1, are generally appropriate for PLWH and cancers for which there are FDA-approved indications. Ongoing and future trials of anti-PD-1 and anti-PD-L1 therapy alone or in combination for HIV-associated cancers may further improve outcomes for this underserved population.
PURPOSE OF REVIEW: Immune checkpoint inhibitors targeting the programmed cell death-1 (PD-1) pathway are a class of anti-cancer immunotherapy agents changing treatment paradigms of many cancers that occur at higher rates in people living with HIV (PLWH) than in the general population. However, PLWH have been excluded from most of the initial clinical trials with these agents. RECENT FINDINGS: Two recent prospective studies of anti-PD-1 agents, along with observational studies and a meta-analysis, have demonstrated acceptable safety in PLWH. Preliminary evidence indicates activity in a range of tumors and across CD4+ T cell counts. Safety and preliminary activity data suggest monoclonal antibodies targeting PD-1 or its ligand, PD-L1, are generally appropriate for PLWH and cancers for which there are FDA-approved indications. Ongoing and future trials of anti-PD-1 and anti-PD-L1 therapy alone or in combination for HIV-associated cancers may further improve outcomes for this underserved population.
Entities:
Keywords:
Cancer; Checkpoint inhibitors; HIV; PD-1; PD-L1; T cell exhaustion
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