Immune checkpoint inhibitors in people living with HIV and cancer: a Kaplan-Meier-derived individual patient data meta-analysis.

INTRODUCTION

Antiretroviral therapy has enabled people living with HIV (PLWH) to achieve near-normal life expectancy, but non-AIDS-defining cancers are increasingly frequent. Immune checkpoint inhibitors (ICIs) may be effective in this population, although evidence remains limited because PLWH have often been excluded from trials. This study assessed the efficacy and safety of ICIs in PLWH.

METHODS

We conducted a systematic review and meta-analysis using Medline, Scopus, Web of Science, and Cochrane Library. Studies reporting outcomes of PLWH with malignancies treated with ICIs were included. Analyses were performed in R version 4.4.2.

RESULTS

Fourteen studies including 935 patients were analyzed. Compared with people living without HIV, PLWH showed no significant differences in overall survival (HR, 0.88; 95% CI, 0.71-1.08; p = 0.23), progression-free survival (HR, 1.13; 95% CI, 0.89-1.42; p = 0.38), any adverse events (OR, 0.90; 95% CI, 0.52-1.58; p = 0.71), or severe adverse events (OR, 1.04; 95% CI, 0.51-2.10; p = 0.91). In PLWH, the pooled objective response rate was 36%, and disease control rate was 64%.

CONCLUSIONS

ICIs showed comparable efficacy and safety in PLWH and people living without HIV.

PROTOCOL REGISTRATION: www.crd.york.ac.uk/prospero identifier is CRD420251113906.