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Immunotherapy for cancer in people living with HIV

safety with an efficacy signal from the series in real life experience

Spano, Jean-Philippea; Veyri, Marianneb; Gobert, Aurélienc; Guihot, Amélied; Perré, Philippee; Kerjouan, Mallorief; Brosseau, Solenng; Cloarec, Nicolash; Montaudié, Henrii; Helissey, Carolej; Flament, Thomask; Gounant, Valérieg; Lavolé, Armellel; Poizot-Martin, Isabellem; Katlama, Christinen

doi: 10.1097/QAD.0000000000002298
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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).

aSorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, équipe Theravir, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Oncologie médicale

bAP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Oncologie médicale, Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, équipe Theravir

cAP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Oncologie médicale, Sorbonne Université

dSorbonne Université, INSERM U1135, Centre d’Immunologie et des Maladies Infectieuses (CIMI-Paris), AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière – Charles Foix, Département d’Immunologie, Paris

eDépartement de Maladies infectieuses, CHD Vendée, La Roche sur Yon

fDépartement de Pneumologie, CHU Pontchaillou, Rennes

gDépartement d’Oncologie thoracique, Hôpital Bichat, Paris

hDépartment d’Hématologie Clinique et d’Oncologie médicale, Hôpital d’Avignon

iDépartement de Dermatologie, Hôpital de l’Archet, Université Côte d’Azur, Centre Hospitalier Universitaire de Nice

jUnité de Recherche Clinique, Oncologie médicale, HIA Bégin, F-94160 Saint-Mandé

kService de Pneumologie, CHU de Tours

lSorbonne Université, GRC n°04, Theranoscan, AP-HP, Service de Pneumologie, Hôpital Tenon, Paris

mAix 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

nSorbonne 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.

Correspondence to Professor Jean-Philippe Spano, Medical Oncology Department, Pitié-Salpêtrière Hospital, APHP.6, 47–83 boulevard de l’Hôpital, 75013 Paris, France. Tel: +33 142160472; e-mail: jean-philippe.spano@aphp.fr

Received 11 March, 2019

Revised 22 May, 2019

Accepted 24 May, 2019

Copyright © 2019 Wolters Kluwer Health, Inc.