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Immune checkpoint inhibitors show comparable efficacy and safety in patients living with HIV and cancerImmune Checkpoint Inhibitors Show Similar Results for Patients with HIV

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Key Takeaway
Note that immune checkpoint inhibitors show comparable efficacy and safety in patients living with HIV and cancer.

This meta-analysis evaluated the efficacy and safety of immune checkpoint inhibitors in patients living with HIV (PLWH) with malignancies. The analysis included a total of 935 patients to compare outcomes between PLWH and individuals without HIV.

Key findings indicate no significant differences in overall survival (HR, 0.88; 95% CI, 0.71-1.08; p=0.23) or progression-free survival (HR, 1.13; 95% CI, 0.89-1.42; p=0.38) between the two groups. Additional reported outcomes included an objective response rate of 36% and a disease control rate of 64%. Safety data showed no significant difference in adverse events (OR, 0.90; 95% CI, 0.52-1.58; p=0.71) or serious adverse events (OR, 1.04; 95% CI, 0.51-2.10; p=0.91) between populations.

The authors note that evidence remains limited because PLWH have often been excluded from clinical trials in the past. Despite this limitation, the data suggest that immune checkpoint inhibitors demonstrate comparable efficacy and safety for patients living with HIV. Clinical application should be interpreted with caution due to the limited scope of available evidence.

How this fits prior evidence

This meta-analysis addresses a gap in evidence regarding the treatment of malignancies in people living with HIV. While previous coverage noted that antibiotic exposure is associated with shorter overall survival in hepatocellular carcinoma patients on ICIs, this study specifically addresses the impact of HIV status on ICI efficacy and safety. The findings suggest that HIV status does not significantly alter the outcomes of immune checkpoint inhibitor therapy compared to patients without HIV.

Researchers looked at how immune checkpoint inhibitors work for people living with HIV who also have cancer. They compared the results of these patients to people living without HIV who were treated with the same type of medication. The study included 935 people in total to look at survival rates and how well the treatment controlled the disease.

The results showed no significant differences in overall survival or progression-free survival between people with HIV and those without HIV. Additionally, the rates for objective response and disease control were 36% and 64% respectively. Safety data also showed no significant differences in serious adverse events between the two groups.

It is important to note that evidence is still limited because people living with HIV are often excluded from many clinical trials. While this study suggests the treatment is comparable for both groups, the findings are based on a meta-analysis of existing data. Patients should talk to their doctors to understand how these results apply to their specific health needs.

What this means for you:
Immune checkpoint inhibitors show similar survival and safety results for people with and without HIV.

Common questions

Are immune checkpoint inhibitors safe for people living with HIV?

The study found no significant differences in serious adverse events between people living with HIV and those without HIV. The odds ratio for serious events was 1.04, which indicates that the treatment was comparable in safety for both groups. You should discuss specific safety concerns with your doctor.

How effective are these treatments for cancer in people with HIV?

The study showed no significant differences in overall survival or progression-free survival for people living with HIV compared to those without HIV. The objective response rate was 36% and the disease control rate was 64% for the group studied.

Is the evidence for these treatments in HIV patients reliable?

The evidence is currently limited because people living with HIV are often excluded from many clinical trials. While this study shows comparable results, the limited amount of data means patients should consult their medical team for personalized care.

Study Details

Study typeMeta analysis
Sample sizen = 935
EvidenceLevel 1
PublishedNov 2026
View Original Abstract ↓
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; = 0.23), progression-free survival (HR, 1.13; 95% CI, 0.89-1.42; = 0.38), any adverse events (OR, 0.90; 95% CI, 0.52-1.58; = 0.71), or severe adverse events (OR, 1.04; 95% CI, 0.51-2.10; = 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.
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