Cancer type-specific adverse events of immune checkpoint inhibitors: A systematic review and meta-analysis
Background: The distribution of adverse events (AEs) triggered by immune checkpoint inhibitors (ICIs) across different cancer types has never been demonstrated. Methods: Randomised controlled trials exclusively assessing ICI monotherapy in cohorts of over 100 patients were considered. Our primary ou...
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| Format: | Article |
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Elsevier
2025-01-01
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| Series: | Heliyon |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844024176281 |
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| author | Xuhui Tong Rong Tang Jin Xu Wei Wang Qiong Du Si Shi Xianjun Yu |
| author_facet | Xuhui Tong Rong Tang Jin Xu Wei Wang Qiong Du Si Shi Xianjun Yu |
| author_sort | Xuhui Tong |
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| description | Background: The distribution of adverse events (AEs) triggered by immune checkpoint inhibitors (ICIs) across different cancer types has never been demonstrated. Methods: Randomised controlled trials exclusively assessing ICI monotherapy in cohorts of over 100 patients were considered. Our primary outcome was a comprehensive summary of the distribution of all-grade treatment-related adverse events (TRAEs) as well as serious TRAEs (CTCAE grade 3 or higher) across different malignancies. The study is registered with PROSPERO CRD42023387934. Findings: 75 trials that enrolled over 100 patients were included. While investigating the incidence of each TRAE across various cancers, we found special linkages existed between certain TRAEs and particular cancer types. In anti-PD-1 monotherapy group, melanoma patients experienced the most frequent fatigue (31.1 %, 95 % CI 29.7%–32.5 %); the incidences of severe pneumonitis and other respiratory disorders were highest in Hodgkin lymphoma (4.1 %, 95 % CI 1.5%–8.6 %; 4.1 %, 95 % CI 1.5%–8.6 %, respectively). Among individuals undergoing single-agent anti-PD-L1, higher frequency of all-grade pruritus occurred in 19.0 % of renal cell carcinoma (RCC) patients (95 % CI 15.2%–23.2 %), and the highest probability of developing other severe musculoskeletal disorders was observed in patients with RCC (6.2 %, 95 % CI 4.0%–9.0 %). In anti-CTLA-4 monotherapy, the incidences of both all-grade and severe diarrhea occurred most frequently in prostate cancer patients (41.9 %, 95 % CI 37.9%–47.9; 14.8 %, 95 % CI 11.5%–18.7 %, respectively). Interpretation: This is the first comprehensive study addressing the distribution of various TRAEs across cancer types. Our research emphasizes the significance of considering cancer-specific TRAEs when using ICIs for treatment. |
| format | Article |
| id | doaj-art-0fc6b03a8a1a4ed2b0e5217c8f14416f |
| institution | Kabale University |
| issn | 2405-8440 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj-art-0fc6b03a8a1a4ed2b0e5217c8f14416f2025-01-17T04:51:43ZengElsevierHeliyon2405-84402025-01-01111e41597Cancer type-specific adverse events of immune checkpoint inhibitors: A systematic review and meta-analysisXuhui Tong0Rong Tang1Jin Xu2Wei Wang3Qiong Du4Si Shi5Xianjun Yu6Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaShanghai Pancreatic Cancer Institute, Shanghai, China; Pancreatic Cancer Institute, Fudan University, Shanghai, ChinaDepartment of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaDepartment of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Department of Pharmacy, Fudan University Shanghai Cancer Center, Shanghai, ChinaShanghai Pancreatic Cancer Institute, Shanghai, China; Pancreatic Cancer Institute, Fudan University, Shanghai, China; Corresponding author. Shanghai Pancreatic Cancer Institute, No. 399 Lingling Road, Shanghai, 200032, China.Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Corresponding author. Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, No. 270 Dong’An Road, Shanghai, 200032, China.Background: The distribution of adverse events (AEs) triggered by immune checkpoint inhibitors (ICIs) across different cancer types has never been demonstrated. Methods: Randomised controlled trials exclusively assessing ICI monotherapy in cohorts of over 100 patients were considered. Our primary outcome was a comprehensive summary of the distribution of all-grade treatment-related adverse events (TRAEs) as well as serious TRAEs (CTCAE grade 3 or higher) across different malignancies. The study is registered with PROSPERO CRD42023387934. Findings: 75 trials that enrolled over 100 patients were included. While investigating the incidence of each TRAE across various cancers, we found special linkages existed between certain TRAEs and particular cancer types. In anti-PD-1 monotherapy group, melanoma patients experienced the most frequent fatigue (31.1 %, 95 % CI 29.7%–32.5 %); the incidences of severe pneumonitis and other respiratory disorders were highest in Hodgkin lymphoma (4.1 %, 95 % CI 1.5%–8.6 %; 4.1 %, 95 % CI 1.5%–8.6 %, respectively). Among individuals undergoing single-agent anti-PD-L1, higher frequency of all-grade pruritus occurred in 19.0 % of renal cell carcinoma (RCC) patients (95 % CI 15.2%–23.2 %), and the highest probability of developing other severe musculoskeletal disorders was observed in patients with RCC (6.2 %, 95 % CI 4.0%–9.0 %). In anti-CTLA-4 monotherapy, the incidences of both all-grade and severe diarrhea occurred most frequently in prostate cancer patients (41.9 %, 95 % CI 37.9%–47.9; 14.8 %, 95 % CI 11.5%–18.7 %, respectively). Interpretation: This is the first comprehensive study addressing the distribution of various TRAEs across cancer types. Our research emphasizes the significance of considering cancer-specific TRAEs when using ICIs for treatment.http://www.sciencedirect.com/science/article/pii/S2405844024176281 |
| spellingShingle | Xuhui Tong Rong Tang Jin Xu Wei Wang Qiong Du Si Shi Xianjun Yu Cancer type-specific adverse events of immune checkpoint inhibitors: A systematic review and meta-analysis Heliyon |
| title | Cancer type-specific adverse events of immune checkpoint inhibitors: A systematic review and meta-analysis |
| title_full | Cancer type-specific adverse events of immune checkpoint inhibitors: A systematic review and meta-analysis |
| title_fullStr | Cancer type-specific adverse events of immune checkpoint inhibitors: A systematic review and meta-analysis |
| title_full_unstemmed | Cancer type-specific adverse events of immune checkpoint inhibitors: A systematic review and meta-analysis |
| title_short | Cancer type-specific adverse events of immune checkpoint inhibitors: A systematic review and meta-analysis |
| title_sort | cancer type specific adverse events of immune checkpoint inhibitors a systematic review and meta analysis |
| url | http://www.sciencedirect.com/science/article/pii/S2405844024176281 |
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