Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 May 22;7(1):130.
doi: 10.1186/s40425-019-0618-9.

Remembering the forgotten child: the role of immune checkpoint inhibition in patients with human immunod eficiency virus and cancer

Jacob J Adashek  1 , Pedro Nazareth Aguiar Junior  2   3 , Natalie Galanina  4 , Razelle Kurzrock  5
Affiliations

Remembering the forgotten child: the role of immune checkpoint inhibition in patients with human immunod eficiency virus and cancer

Jacob J Adashek et al. J Immunother Cancer. .

Abstract

Patients with human immunodeficiency virus (HIV) infection have a high risk of developing virally-mediated cancers. These tumors have several features that could make them vulnerable to immune checkpoint inhibitors (ICIs) including, but not limited to, increased expression of the CTLA-4 and PD-1 checkpoints on their CD4+ T cells. Even so, HIV-positive patients are generally excluded from immunotherapy cancer clinical trials due to safety concerns. Hence, only case series have been published regarding HIV-positive patients with cancer who received ICIs, but these reports of individuals with a variety of malignancies demonstrate that ICIs have significant activity, exceeding a 65% objective response rate in Kaposi sarcoma. Furthermore, high-grade immune toxicities occurred in fewer than 10% of treated patients. The existing data suggest that the underlying biologic mechanisms that mediate development of cancer in HIV-infected patients should render them susceptible to ICI treatment. Preliminary, albeit limited, clinical experience indicates that checkpoint blockade is both safe and efficacious in this setting. Additional clinical trials that include HIV-positive patients with cancer are urgently needed.

Keywords: Cancer clinical trials; Human immunodeficiency virus; Immune checkpoint inhibitors; Immunotherapy.

PubMed Disclaimer

Conflict of interest statement

JJA has no disclosures. RK has the following disclosure information: Stock and Other Equity Interests (IDbyDNA, CureMatch, Inc., and Soluventis); Consulting or Advisory Role (Gaido, LOXO, X-Biotech, Actuate Therapeutics, Roche, NeoMed, and Soluventis); Speaker’s fee (Roche); Research Funding (Incyte, Genentech, Merck Serono, Pfizer, Sequenom, Foundation Medicine, Guardant Health, Grifols, Konica Minolta, and OmniSeq [All institutional]); Board Member (CureMatch, Inc). NG has no disclosures. PNA reports speaker fees from Merck, outside the submitted work.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Thompson MP, Kurzrock R. Epstein-Barr virus and cancer. Clin Cancer Res. 2004;10(3):803–821. doi: 10.1158/1078-0432.CCR-0670-3. - DOI - PubMed
    1. Morris VK, Salem ME, Nimeiri H, et al. Nivolumab for previously treated unresectable metastatic anal cancer (NCI9673): a multicentre, single-arm, phase 2 study. Lancet Oncol. 2017;18(4):446–453. doi: 10.1016/S1470-2045(17)30104-3. - DOI - PMC - PubMed
    1. Sandoval-Sus JD, Mogollon-Duffo F, Patel A, et al. Nivolumab as salvage treatment in a patient with HIV-related relapsed/refractory Hodgkin lymphoma and liver failure with encephalopathy. J Immunother Cancer. 2017;5:49. doi: 10.1186/s40425-017-0252-3. - DOI - PMC - PubMed
    1. Galanina N, Goodman AM, Cohen PR, Frampton GM, Kurzrock R. Successful treatment of HIV-associated Kaposi sarcoma with immune checkpoint blockade. Cancer Immunol Res. 2018;6(10):1129–1135. doi: 10.1158/2326-6066.CIR-18-0121. - DOI - PMC - PubMed
    1. Heppt MV, Schlaak M, Eigentler TK, et al. Checkpoint blockade for metastatic melanoma and Merkel cell carcinoma in HIV-positive patients. Ann Oncol. 2017;28(12):3104–3106. doi: 10.1093/annonc/mdx538. - DOI - PubMed

Publication types

MeSH terms

Substances