학술논문
Human Immunodeficiency Virus Is Associated With Poor Overall Survival Among Patients With Head and Neck Cancer.
Document Type
Academic Journal
Author
Salahuddin S; Department of Internal Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut, USA.; Cohen O; Department of Otolaryngology, Head and Neck Surgery, Soroka Medical Center, Scarsdale, New York, USA.; Wu M; Department of Pediatrics, Northwestern University, Chicago, Illinois, USA.; Perez Irizarry J; Yale Cancer Center, Yale New Haven Hospital, New Haven, Connecticut, USA.; Vega T; Yale Cancer Center, Yale New Haven Hospital, New Haven, Connecticut, USA.; Gan G; Yale Center for Analytic Sciences, Yale University School of Public Health, New Haven, Connecticut, USA.; Deng Y; Yale Center for Analytic Sciences, Yale University School of Public Health, New Haven, Connecticut, USA.; Isaeva N; Department of Otolaryngology/Head and Neck Surgery and Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.; Prasad M; Department of Pathology, Yale University School of Medicine, New Haven, Connecticut, USA.; Schalper KA; Department of Pathology, Yale University School of Medicine, New Haven, Connecticut, USA.; Mehra S; Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA.; Yarbrough WG; Department of Otolaryngology/Head and Neck Surgery and Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.; Emu B; Department of Internal Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut, USA.; Department of Pathology, Yale University School of Medicine, New Haven, Connecticut, USA.
Source
Publisher: Oxford University Press Country of Publication: United States NLM ID: 9203213 Publication Model: Print Cited Medium: Internet ISSN: 1537-6591 (Electronic) Linking ISSN: 10584838 NLM ISO Abbreviation: Clin Infect Dis Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Head and neck squamous cell cancer (HNSCC) occurs at higher rates among persons with HIV (PWH). This study compares the impact of sociodemographic and clinicopathologic characteristics on outcomes among PWH-HNSCC compared with HNSCC patients without HIV.
Methods: Patient data from HNSCC individuals were collected at a single academic hospital center between 2002 and 2018. Forty-eight patients with HIV (HIV-HNSCC) and 2894 HNSCC patients without HIV were included. Multivariate analysis determined predictors of survival using Cox proportional hazards regression model. HIV-positive and -negative tumors were analyzed by quantitative immunofluorescence for expression of CD4, CD8, CD20 and PD-L1.
Results: HIV-HNSCC patients had a lower median overall survival than HNSCC patients without HIV (34 [18-84] vs 94 [86-103] months; P < .001). In multivariate analysis that included age, sex, race/ethnicity, stage, site, tobacco use, time to treatment initiation, and insurance status, HIV was an independent predictor of poorer survival, with a hazard ratio of 1.98 (95% CI: 1.32-2.97; P < .001). PWH with human papillomavirus (HPV)-positive oropharyngeal tumors also had worse prognosis than HPV-positive oropharyngeal tumors in the population without HIV (P < .001). The tumor microenvironment among HIV-HNSCC patients revealed lower intratumoral CD8 infiltration among HIV+ HPV+ tumors compared with HIV- HPV+ tumors (P = .04).
Conclusions: HIV-HNSCC patients had worse prognosis than the non-HIV population, with HIV being an independent predictor of poor clinical outcomes when accounting for important sociodemographic and clinicopathologic factors. Our findings highlight differences in tumor biology that require further detailed characterization in large cohorts and increased inclusion of PWH in immunotherapy trials.
Competing Interests: Potential conflicts of interest. B. E. reports consulting fees from Theratechnologies and Genentech/Roche unrelated to this work; participation on an Advisory Board for Theratechnologies unrelated to this work; and stock or stock options with Bausch Health Companies and Bristol Myers Squibb. G. G. reports support unrelated to this work from the Yale Transplant Group (author works as a statistician working at the Yale Center for Analytical Sciences; part of the author's effort is covered by Yale Transplant for providing statistical support for their research studies). K. A. S. reports grants or contracts unrelated to this work from Navigate Biopharma, Tesaro/GSK, Moderna, Inc, Takeda, Surface Oncology, Pierre-Fabre Research Institute, Merck, Bristol-Myers Squibb, AstraZeneca, Ribon Therapeutics, Eli Lilly, Boehringer-Ingelheim, and Akoya Biosciences (all contracted to Yale University); consulting fees paid to the author from Clinica Alemana Santiago, Shattuck Labs, Genmab, AstraZeneca, EMD Serono, Takeda, Torque/Repertoire Therapeutics, Takeda, Agenus, Genmab, OnCusp, Parthenon Therapeutics, Bristol-Myers Squibb, Roche, CDR Life, Sensei Therapeutics, Molecular Templates, and Merck; payment or honoraria for lectures, presentations, speaker’s bureaus, manuscript writing, or educational events from PeerView, Forefront Collaborative, Merck; payment for expert testimony from AstraZeneca; and support for attending meetings and/or travel from Fluidigm. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.
(© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Methods: Patient data from HNSCC individuals were collected at a single academic hospital center between 2002 and 2018. Forty-eight patients with HIV (HIV-HNSCC) and 2894 HNSCC patients without HIV were included. Multivariate analysis determined predictors of survival using Cox proportional hazards regression model. HIV-positive and -negative tumors were analyzed by quantitative immunofluorescence for expression of CD4, CD8, CD20 and PD-L1.
Results: HIV-HNSCC patients had a lower median overall survival than HNSCC patients without HIV (34 [18-84] vs 94 [86-103] months; P < .001). In multivariate analysis that included age, sex, race/ethnicity, stage, site, tobacco use, time to treatment initiation, and insurance status, HIV was an independent predictor of poorer survival, with a hazard ratio of 1.98 (95% CI: 1.32-2.97; P < .001). PWH with human papillomavirus (HPV)-positive oropharyngeal tumors also had worse prognosis than HPV-positive oropharyngeal tumors in the population without HIV (P < .001). The tumor microenvironment among HIV-HNSCC patients revealed lower intratumoral CD8 infiltration among HIV+ HPV+ tumors compared with HIV- HPV+ tumors (P = .04).
Conclusions: HIV-HNSCC patients had worse prognosis than the non-HIV population, with HIV being an independent predictor of poor clinical outcomes when accounting for important sociodemographic and clinicopathologic factors. Our findings highlight differences in tumor biology that require further detailed characterization in large cohorts and increased inclusion of PWH in immunotherapy trials.
Competing Interests: Potential conflicts of interest. B. E. reports consulting fees from Theratechnologies and Genentech/Roche unrelated to this work; participation on an Advisory Board for Theratechnologies unrelated to this work; and stock or stock options with Bausch Health Companies and Bristol Myers Squibb. G. G. reports support unrelated to this work from the Yale Transplant Group (author works as a statistician working at the Yale Center for Analytical Sciences; part of the author's effort is covered by Yale Transplant for providing statistical support for their research studies). K. A. S. reports grants or contracts unrelated to this work from Navigate Biopharma, Tesaro/GSK, Moderna, Inc, Takeda, Surface Oncology, Pierre-Fabre Research Institute, Merck, Bristol-Myers Squibb, AstraZeneca, Ribon Therapeutics, Eli Lilly, Boehringer-Ingelheim, and Akoya Biosciences (all contracted to Yale University); consulting fees paid to the author from Clinica Alemana Santiago, Shattuck Labs, Genmab, AstraZeneca, EMD Serono, Takeda, Torque/Repertoire Therapeutics, Takeda, Agenus, Genmab, OnCusp, Parthenon Therapeutics, Bristol-Myers Squibb, Roche, CDR Life, Sensei Therapeutics, Molecular Templates, and Merck; payment or honoraria for lectures, presentations, speaker’s bureaus, manuscript writing, or educational events from PeerView, Forefront Collaborative, Merck; payment for expert testimony from AstraZeneca; and support for attending meetings and/or travel from Fluidigm. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.
(© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)