Ahmed D Alatawi, Amirah B Alaqyl, Reema J Alalawi, Rahaf S Alqarni, Razan A Sufyani, Ghadi S Alqarni, Raghad S Alqarni, Jumana H Albalawi, Raghad A Alsharif, Ghada I Alatawi, Elaf N Albalawi, Danah A Alanazi, Sultanah A Naitah, Reem Sayad, Helal F Hetta
{"title":"Safety and Efficacy of Immune Checkpoint Inhibitors in Human Immunodeficiency Virus-Associated Cancer: A Systematic Scoping Review.","authors":"Ahmed D Alatawi, Amirah B Alaqyl, Reema J Alalawi, Rahaf S Alqarni, Razan A Sufyani, Ghadi S Alqarni, Raghad S Alqarni, Jumana H Albalawi, Raghad A Alsharif, Ghada I Alatawi, Elaf N Albalawi, Danah A Alanazi, Sultanah A Naitah, Reem Sayad, Helal F Hetta","doi":"10.3390/diseases13080230","DOIUrl":null,"url":null,"abstract":"<p><p><b>Background/Objective:</b> People living with human immunodeficiency virus (PHIV) are at increased risk for malignancies, yet their access to immunotherapy remains limited due to concerns about safety and efficacy. This systematic scoping review evaluates the use of immune checkpoint inhibitors (ICIs) in HIV-associated cancers, analyzing patient outcomes, safety profiles, and the impact on HIV status. <b>Methods:</b> A comprehensive literature search was conducted in databases including PubMed, Scopus, Web of Science (WoS), and Medline, up to January 2025. Studies included assessing the efficacy of ICIs in cancer patients with HIV. The primary outcomes were (a) the efficacy of immune ICIs on prognosis, progression-free survival (PFS), and overall survival (OS). Secondary outcomes were the immune-related adverse events (irAEs) and the survival rate of cancer patients receiving ICIs. <b>Results:</b> A total of 107 cases from 19 studies published between 2011 and 2024 were reviewed. Responses to programmed death 1 (PD-1) inhibitors varied, with 27.1% achieving partial response, 23.36% experiencing stable disease, and 6.54% achieving complete response, while 34.57% had disease progression. Adverse events, including hematologic and endocrine toxicities, were common but mostly manageable. HIV viral loads remained stable in most cases. <b>Conclusions:</b> PD-1 inhibitors demonstrated potential efficacy in HIV-associated malignancies with a safety profile comparable to the general population. However, disease progression remained a concern, highlighting the need for optimized patient selection. Further well-controlled trials are essential to establish treatment guidelines and ensure equitable access to immunotherapy for PHIV.</p>","PeriodicalId":72832,"journal":{"name":"Diseases (Basel, Switzerland)","volume":"13 8","pages":""},"PeriodicalIF":3.0000,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12385830/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diseases (Basel, Switzerland)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3390/diseases13080230","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0
Abstract
Background/Objective: People living with human immunodeficiency virus (PHIV) are at increased risk for malignancies, yet their access to immunotherapy remains limited due to concerns about safety and efficacy. This systematic scoping review evaluates the use of immune checkpoint inhibitors (ICIs) in HIV-associated cancers, analyzing patient outcomes, safety profiles, and the impact on HIV status. Methods: A comprehensive literature search was conducted in databases including PubMed, Scopus, Web of Science (WoS), and Medline, up to January 2025. Studies included assessing the efficacy of ICIs in cancer patients with HIV. The primary outcomes were (a) the efficacy of immune ICIs on prognosis, progression-free survival (PFS), and overall survival (OS). Secondary outcomes were the immune-related adverse events (irAEs) and the survival rate of cancer patients receiving ICIs. Results: A total of 107 cases from 19 studies published between 2011 and 2024 were reviewed. Responses to programmed death 1 (PD-1) inhibitors varied, with 27.1% achieving partial response, 23.36% experiencing stable disease, and 6.54% achieving complete response, while 34.57% had disease progression. Adverse events, including hematologic and endocrine toxicities, were common but mostly manageable. HIV viral loads remained stable in most cases. Conclusions: PD-1 inhibitors demonstrated potential efficacy in HIV-associated malignancies with a safety profile comparable to the general population. However, disease progression remained a concern, highlighting the need for optimized patient selection. Further well-controlled trials are essential to establish treatment guidelines and ensure equitable access to immunotherapy for PHIV.
背景/目的:人类免疫缺陷病毒(PHIV)感染者患恶性肿瘤的风险增加,但由于对安全性和有效性的担忧,他们获得免疫治疗的机会仍然有限。本系统的范围综述评估了免疫检查点抑制剂(ICIs)在HIV相关癌症中的使用,分析了患者结局、安全性概况以及对HIV状态的影响。方法:对截至2025年1月的PubMed、Scopus、Web of Science (WoS)、Medline等数据库进行综合文献检索。研究包括评估ICIs对感染艾滋病毒的癌症患者的疗效。主要结局是(a)免疫ICIs对预后、无进展生存期(PFS)和总生存期(OS)的影响。次要结局是免疫相关不良事件(irAEs)和接受ICIs治疗的癌症患者的生存率。结果:回顾了2011年至2024年间发表的19项研究共107例。程序性死亡1 (PD-1)抑制剂的反应各不相同,27.1%达到部分缓解,23.36%达到疾病稳定,6.54%达到完全缓解,而34.57%出现疾病进展。不良事件,包括血液学和内分泌毒性,是常见的,但大多是可控的。在大多数情况下,HIV病毒载量保持稳定。结论:PD-1抑制剂在hiv相关恶性肿瘤中显示出潜在的疗效,其安全性与一般人群相当。然而,疾病进展仍然是一个问题,突出了优化患者选择的必要性。进一步的良好对照试验对于制定治疗指南和确保公平获得艾滋病毒免疫治疗至关重要。