Meta‐analysis of immune‐related adverse events of immune checkpoint inhibitor therapy in cancer patients

Song, Peng; Zhang, Dingding; Cui, Xiaoxia; Zhang, Li

doi:10.1111/1759-7714.13541

Cited by 48 publications

(61 citation statements)

References 147 publications

(247 reference statements)

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“…Immune checkpoint inhibitors (ICI) are associated with a broad spectrum of unique immune-mediated toxicities, requiring expert management, as these toxicities may occasionally be life threatening [144]. Immune-mediated toxicities can affect most organ systems and are believed to arise from autoimmune inflammatory complications of ICI treatment.…”

Section: Immune Related Toxicitymentioning

confidence: 99%

Immune Checkpoint Blockade in Gynecologic Cancers: State of Affairs

Drakes

Czerlanis

Stiff

2020

Cancers

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This review provides an update on the current use of immune checkpoint inhibitors (ICI) in female gynecologic cancers, and it addresses the potential of these agents to provide therapy options for disease management and long-term remission in advanced disease patients, where surgery, chemotherapy, and/or radiation fail to meet this goal. The topic of immune checkpoint inhibitors (ICI) blocking cytotoxic T lymphocyte associated protein-4 (CTLA-4) and the programmed death-1 (PD-1) axis has come to the forefront of translational medicine over the last decade for several malignancies. The text will focus primarily on a discussion of ovarian cancer, which is the most frequent cause of death of gynecologic cancers; endometrial cancer, which is the most often diagnosed gynecologic cancer; and cervical cancer, which is the third most common female gynecologic malignancy, all of which unfavorably alter the lives of many women. We will address the critical factors that regulate the outcome of these cancer types to ICI therapy, the ongoing clinical trials in this area, as well as the adverse immune responses that impact the outcome of patients given ICI regimens.

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Section: Immune Related Toxicitymentioning

confidence: 99%

Immune Checkpoint Blockade in Gynecologic Cancers: State of Affairs

Drakes

Czerlanis

Stiff

2020

Cancers

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“…However, ICI, as well as some other immunotherapy approaches such as cytokine administration, can stimulate the immune system non-specifically, and hence, they can also trigger the activation of self-reactive lymphocytes. Therefore, immune-related adverse effects (irAEs) such as skin lesions, colitis, and thyroiditis might occur due to an autoimmune attack, limiting the clinical benefit of these treatments [ 6 ]. As these therapies are finding their place in the clinic rather quickly, evading irAEs and stratifying patients at a risk of developing immune toxicities are becoming particularly important.…”

Section: Introductionmentioning

confidence: 99%

Autoimmune Responses in Oncology: Causes and Significance

Bareke

Juanes-Velasco

Landeira-Viñuela

et al. 2021

IJMS

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Specific anti-tumor immune responses have proven to be pivotal in shaping tumorigenesis and tumor progression in solid cancers. These responses can also be of an autoimmune nature, and autoantibodies can sometimes be present even before the onset of clinically overt disease. Autoantibodies can be generated due to mutated gene products, aberrant expression and post-transcriptional modification of proteins, a pro-immunogenic milieu, anti-cancer treatments, cross-reactivity of tumor-specific lymphocytes, epitope spreading, and microbiota-related and genetic factors. Understanding these responses has implications for both basic and clinical immunology. Autoantibodies in solid cancers can be used for early detection of cancer as well as for biomarkers of prognosis and treatment response. High-throughput techniques such as protein microarrays make parallel detection of multiple autoantibodies for increased specificity and sensitivity feasible, affordable, and quick. Cancer immunotherapy has revolutionized cancer treatments and has made a considerable impact on reducing cancer-associated morbidity and mortality. However, immunotherapeutic interventions such as immune checkpoint inhibition can induce immune-related toxicities, which can even be life-threatening. Uncovering the reasons for treatment-induced autoimmunity can lead to fine-tuning of cancer immunotherapy approaches to evade toxic events while inducing an effective anti-tumor immune response.

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“…In the aspect of safety index, the severity of adverse event was divided into five grades. The most common adverse reactions were reactive capillary hyperplasia (77.4%), elevated aspartate aminotransferase (19.0%), elevated alanine aminotransferase (17.5%), hypothyroidism (16.7%), fatigue (15.3%), anemia (14.1%), elevated serum bilirubin (11.5%), proteinuria (10.8%), fever (10.4%), and leukopenia (10%) (27,28). Through metaanalysis, we found that when the grade of adverse events was > 2, the incidence of single use was lower than combination therapy and chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Camrelizumab Monotherapy and Combination Therapy for Cancers: A Systematic Review and Meta-Analysis

Wang

et al. 2021

Front. Oncol.

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ObjectiveThis meta-analysis compared the safety and efficacy of camrelizumab monotherapy and combination therapy, aiming to provide a reference for the clinical combined use of camrelizumab in the treatment of cancers and also provide a reference for the development of subsequent indications of camrelizumab.MethodsMeta-analysis was used to analyze the four eligible literatures. Primary endpoints of effectiveness index were objective response rate (ORR), progression-free survival (PFS), control rate (CR). Primary endpoint of safety index was rating of severity of adverse drug reactions (grades 1–5).ResultsThe ORR, PFS, and CR values of combined treatment with camrelizumab was better than alone treatment, camrelizumab alone was better than chemotherapy (RR = 0.45; 95% CI, 0.30–0.67; P < 0.001; RR = 1.63; 95% CI, 1.25–2.13; P < 0.001; RR = 0.73; 95% CI, 0.52–1.02; P<0.001). When grade > 2, the incidence rate of combined treatment and chemotherapy are higher than monotherapy (RR = 0.66; 95% CI, 0.51–0.86; P<0.001). In any grade, the safety of camrelizumab combination therapy was better than that of monotherapy, the safety of chemotherapy was better than camrelizumab plus chemotherapy.ConclusionIn terms of effectiveness, the combination of camrelizumab is better than monotherapy, and monotherapy is better than chemotherapy. In terms of safety, when the grade > 2, single use is better than combination therapy and chemotherapy. In any grade of adverse event, the safety of combined use of camrelizumab is better than that of single use, and the safety of chemotherapy is better than the combined use of camrelizumab plus chemotherapy.

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Meta‐analysis of immune‐related adverse events of immune checkpoint inhibitor therapy in cancer patients

Cited by 48 publications

References 147 publications

Immune Checkpoint Blockade in Gynecologic Cancers: State of Affairs

Immune Checkpoint Blockade in Gynecologic Cancers: State of Affairs

Autoimmune Responses in Oncology: Causes and Significance

Efficacy and Safety of Camrelizumab Monotherapy and Combination Therapy for Cancers: A Systematic Review and Meta-Analysis

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