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Immunotherapy for cancer in people living with HIV: safety with an efficacy signal from the series in real life experience on behalf of the French CANCERVIH network.

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. 23 patients were treated with ICI 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 non-small 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/mm (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 5 patients (22%), a stabilization for 5 (22%) and a progression in 13 (57%). Only one patient experienced a positive HIV viral load, but this occurred following ART interruption.


CONCLUSIONS
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).