Neil J. Shah, MBBS

Neil J. Shah, MBBS, a medical oncologist at Memorial Sloan Kettering Cancer Center, New York, called the cohort study “one of a kind” because of the ability to match baseline cohorts of people living with and without HIV and metastatic non–small cell lung cancer.

“These findings should be very encouraging for people living with HIV,” Dr. Shah told The ASCO Post. “They show that having HIV should not influence patients’ choice for treatment, especially with immune checkpoint inhibitors.”

According to Dr. Shah, however, patients living with HIV in this study were also shown to have high CD4-positve cell counts (> 300 cells/mm³), which suggests less risk of opportunistic infection. It’s uncertain what happens in patients with very low CD4 counts, he said, but given the effective treatments of HIV, there should be no increased safety signals or side effects associated with immune checkpoint inhibitors.

Although providers “should be careful when extrapolating these data” from one cancer type to another when it comes to the efficacy of immune checkpoint inhibitors, said Dr. Shah, these medications appear to be safe in this population. Dr. Shah also noted that ongoing, prospective studies of people living with HIV will help to answer any remaining safety questions for this population, which has been historically excluded from clinical trials.

“In the meantime, these retrospective data should help to reassure patients and providers about the safety of immunotherapy for people living with HIV, but randomized, prospective, controlled trials will be even better,” he concluded. 

DISCLOSURE: Dr. Shah reported no conflicts of interest.