Immunotherapy Checkpoint Inhibitors for Patients with Combined Immunodeficiency

Abstract

As a major breakthrough in the field of tumor immunotherapy, immune checkpoint inhibitors (ICIs) have shown significant efficacy in the treatment of various malignant tumors. However, the application of ICIs in patients with combined immunodeficiency diseases still faces great challenges. Immunodeficiency includes primary and secondary types. Patients have a significantly increased risk of tumors due to low immune function, such as HIV-infected patients, organ transplant recipients, and systemic lupus erythematosus patients. Although early studies have shown that HIV-infected patients did not experience an increase in viral load or a significant decrease in CD4+ T cells after ICIs treatment, and the anti-tumor effect was comparable to that of ordinary patients, long-term safety and optimal treatment strategies still need to be further explored. For patients with primary immunodeficiency, due to congenital defects in the immune system, their responsiveness to ICIs is limited, and there may be a higher risk of immune-related adverse events (irAEs). This article reviews the research progress of ICIs in immunodeficiency-related malignancies, explores key issues such as mechanism conflicts, safety and efficacy in their application, and proposes new directions for future individualized treatment and combination therapy, in order to provide more effective treatment options for this special group.