Anti-PD-1 and Anti-PD-L1 Monoclonal Antibodies in People Living with HIV and Cancer
- PDF / 908,188 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 44 Downloads / 129 Views
CO-INFECTIONS AND COMORBIDITY (S NAGGIE, SECTION EDITOR)
Anti-PD-1 and Anti-PD-L1 Monoclonal Antibodies in People Living with HIV and Cancer Kathryn Lurain 1 & Ramya Ramaswami 1 & Robert Yarchoan 1 & Thomas S. Uldrick 2,3,4,5
# This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply 2020
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. Summary 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-PDL1 therapy alone or in combination for HIV-associated cancers may further improve outcomes for this underserved population. Keywords PD-1 . PD-L1 . Checkpoint inhibitors . HIV . Cancer . T cell exhaustion
Introduction People living with HIV (PLWH) who start antiretroviral therapy (ART) and maintain a suppressed HIV viral load can now experience a life expectancy close to that of the general population, especially if ART is started before profound immunosuppression [1]. Despite progress in HIV care, cancer remains one of the most common causes of morbidity and mortality among PLWH worldwide [2•, 3]. People with uncontrolled HIV and low This article is part of the Topical Collection on Co-infections and Comorbidity * Thomas S. Uldrick [email protected] 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
3
Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, USA
4
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, USA
5
Medical Oncology Division, University of Washington, 1100 Fairview Avenue North, Mail Stop M1-B140, Seattle, USA
CD4+ T cell counts remain at particularly high risk for Kaposi sarcoma (KS), non-Hodgkin lymphoma (NHL), and cervical cancer. There was a significant decrease in the incidence of these cancers after the widespread introduction of combination ART in 1996 [4]. However, even with excellent viral control and immune reconstitution, PLWH remain at increased risk for a range of cancers, especially lung cancer and those driven by oncogenic viruses [5]. Also, as PLWH live longer, they remain at risk
Data Loading...
