Complete response to ipilimumab and nivolumab therapy in a patient with extensive extrapulmonary high-grade small cell carcinoma of the pancreas and HIV infection

• DOI: 10.1186/s40425-018-0379-x
• Publication Date: 2018-07-09T09:10:59Z
• Authors: Muhammad Husnain; Wungki Park; Juan Carlos Ramos; Thomas E. Johnson; Joseph Chan; Arvind Dasari; Raja Mudad; Peter J. Hosein
• Keywords: Male; Case Report; HIV Infections; Small cell cancer; 03 medical and health sciences; Antineoplastic Agents, Immunological; 0302 clinical medicine; Antineoplastic Combined Chemotherapy Protocols; Check point inhibitors; Humans; Carcinoma, Small Cell; RC254-282; HIV; Neoplasms. Tumors. Oncology. Including cancer and carcinogens; Middle Aged; Ipilimumab; 3. Good health; Pancreatic Neoplasms; Nivolumab; Treatment Outcome; Positron-Emission Tomography; Neuroendocrine carcinoma; Immunotherapy; Tomography, X-Ray Computed

Immune checkpoint inhibitors (CPIs) have shown promising results in many solid tumors. There are limited data on the safety and efficacy of these drugs in HIV infected patients as they have traditionally been excluded from CPIs clinical trials.We present a case of an HIV-positive patient with extensive extrapulmonary high-grade small cell carcinoma who was treated with dual CPIs (nivolumab and ipilimumab) with a complete response to therapy and with a manageable safety profile. We performed a comprehensive literature review identifying 62 total HIV positive cases treated with CPIs showing this to be a potentially safe option in HIV-positive patients.HIV infection is not an absolute contraindication to CPI therapy. Our case and others provide justification for ongoing trials of CPI therapy in patients with HIV infection, a group that has traditionally been excluded from clinical trials.