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Peer-reviewedCC BY 4.0Frontiers in Immunology

Immune-checkpoint blockade and candidate predictive biomarkers in HIV-negative Kaposi sarcoma: current evidence and a practical research framework

  • Yang Song1,2
  • Yan Fang1
  • Lin Zeng1
  • Hua Guan1
  1. 1Department of Oncology, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital
  2. 2School of Medicine, University of Electronic Science and Technology of China
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Abstract

Kaposi sarcoma (KS) is a KSHV/HHV-8-driven vascular neoplasm with heterogeneous HIV-negative epidemiological settings. Immune-checkpoint blockade is biologically plausible, but direct clinical evidence remains limited to a small, non-comparative phase II cohort of pembrolizumab in classic or endemic KS. Its 71% best objective response rate is a signal that warrants confirmation, not comparative evidence or a basis for biomarker-guided treatment. This narrative review distinguishes established clinical observations from candidate translational hypotheses, appraises analytical and biological limitations of proposed markers, and outlines requirements for prospective subtype-stratified validation. PD-L1 expression, tumor mutational burden, and KSHV DNA should not be used as stand-alone selection or exclusion tests in routine care.

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Cite

BibTeXRIS
BibTeX
@article{song2026immunecheckpoint,
  title = {{Immune-checkpoint blockade and candidate predictive biomarkers in HIV-negative Kaposi sarcoma: current evidence and a practical research framework}},
  author = {Yang Song and Yan Fang and Lin Zeng and Hua Guan},
  journal = {Frontiers in Immunology},
  year = {2026},
  month = oct,
  doi = {10.3389/fimmu.2026.1979969},
  url = {https://www.frontiersin.org/articles/10.3389/fimmu.2026.1979969/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Immune-checkpoint blockade and candidate predictive biomarkers in HIV-negative Kaposi sarcoma: current evidence and a practical research framework
AU  - Yang Song
AU  - Yan Fang
AU  - Lin Zeng
AU  - Hua Guan
PY  - 2026
DA  - 2026/10/16
JO  - Frontiers in Immunology
DO  - 10.3389/fimmu.2026.1979969
UR  - https://www.frontiersin.org/articles/10.3389/fimmu.2026.1979969/full
AB  - Kaposi sarcoma (KS) is a KSHV/HHV-8-driven vascular neoplasm with heterogeneous HIV-negative epidemiological settings. Immune-checkpoint blockade is biologically plausible, but direct clinical evidence remains limited to a small, non-comparative phase II cohort of pembrolizumab in classic or endemic KS. Its 71% best objective response rate is a signal that warrants confirmation, not comparative evidence or a basis for biomarker-guided treatment. This narrative review distinguishes established clinical observations from candidate translational hypotheses, appraises analytical and biological limitations of proposed markers, and outlines requirements for prospective subtype-stratified validation. PD-L1 expression, tumor mutational burden, and KSHV DNA should not be used as stand-alone selection or exclusion tests in routine care.
SN  - 1664-3224
ER  -