Risk of Infection with Immune Checkpoint Inhibitors: A Systematic Review and Meta-analysis

Petrelli, Fausto; Morelli, Anna; Luciani, Andrea; Ghidini, Antonio; Solinas, Cinzia

doi:10.1007/s11523-021-00824-3

Cited by 19 publications

(16 citation statements)

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“…In the case of patients with NSCLC, combining ICIs with chemotherapy inevitably increases the incidence of serious adverse events ( Petrelli et al, 2021 ). A study investigating irAEs of thoracic malignancies suggested that the incidence of elevated amylase levels in NSCLC patients caused by ICI was 0.6–3% ( Remon et al, 2018 ), which is basically consistent with this study.…”

Section: Discussionmentioning

confidence: 99%

Pancreatic injury following immune checkpoint inhibitors: A systematic review and meta-analysis

Zhang

Wang

Shi³

et al. 2022

Front. Pharmacol.

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Background: Pancreatic injury (pancreatitis, amylase/lipase elevation) is a rare adverse event of immune checkpoint inhibitors (ICIs). With the high number of clinical studies on ICIs, the incidence and characteristics of associated pancreatic injury (PI) need to be reevaluated.Methods: A systematic review and meta-analysis was conducted to assess the incidence of PI in cancer patients who received ICIs in randomized controlled trials (RCTs). PubMed, Embase, the ASCO, ESMO, and AACR conference proceedings before 1 April 2022, were investigated for relevant research.Results: 50 RCTs involving 35,223 patients were included. The incidence of ICIs-PI was 2.22% (95% CI = 1.94%–2.53%). The incidence of PI was 3.76% (95% CI = 1.84–7.67%) when combining two ICIs, which was higher than single ICIs [2.25% (95% CI = 1.91–2.65%)]. The ICIs were ranked from high to low based on PI incidence: PD-L1 inhibitors 3.01% (95% CI = 1.86–4.87%), CTLA-4 inhibitors 2.92% (95% CI = 0.99–8.65%) and PD-1 Inhibitor 2% (95% CI = 1.67–2.39%). The ICI with the highest rate of PI was pembrolizumab 7.23.% (95% CI = 1.69–30.89%). In addition, the incidence of severe ICIs-PI was 2.08% (95% CI = 1.76–2.46%); and the incidence of severe PI was 2.32% (95% CI = 1.76–3.06%) when combining two ICIs, which was higher than single ICI [1.95% (95% CI = 1.58–2.41%)]. The ICIs were ranked from high to low according to the incidence of severe PI: PD-L1 inhibitors 3.1% (95% CI = 1.7–5.64%), CTLA-4 inhibitors 2.69% (95% CI = 0.76–9.49%), PD-1 inhibitors 1.80% (95% CI = 1.41–2.29%).Conclusion: Treatment with multiple ICIs result in a higher incidence of PI compared to single ICIs, irrespective of the grade of pancreatic injury. The incidence of PI caused by PD-L1 inhibitors is higher than that of CTLA-4 inhibitors and PD-1 Inhibitor, and Pembrolizumab has the highest rate of ICIs-PI. Although the incidence of ICIs-PI is not high, they are usually severe (≥ grade 3 events).

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Section: Discussionmentioning

confidence: 99%

Pancreatic injury following immune checkpoint inhibitors: A systematic review and meta-analysis

Zhang

Wang

Shi³

et al. 2022

Front. Pharmacol.

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“…G-CSF prophylaxis is therefore indicated with the combination especially in patients with risk factors of infection during neutropenia, such as shown in Fig. 1 [107].…”

Section: Neutropenia In Therapy With Immune Checkpoint Inhibitorsmentioning

confidence: 99%

Current state and future opportunities in granulocyte colony-stimulating factor (G-CSF)

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2022

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“…Many Phase 3 clinical trials have confirmed anti-PD-1 treatments in advanced NSCLC patients, either as a second-line 15–17 or first-line treatment, 18 which provided improved efficacy and survival, but not increased the infection risk. 19 Compared with second-line docetaxel chemotherapy, treatment with nivolumab or pembrolizumab provided a better ORR and OS. 20–22 The combination of anlotinib hydrochloride and Immune checkpoint inhibitors is effective and well-tolerated in patients with NSCLC.…”

Section: Introductionmentioning

confidence: 99%

Anlotinib Hydrochloride and PD-1 Blockade as a Salvage Second-Line Treatment in Patients with Progress of Local Advanced Non-Small Cell Lung Cancer in Half a Year After Standard Treatment

Yu¹,

Jiang²,

Yang³

et al. 2022

OTT

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Purpose As for local advanced non-small cell lung cancer (NSCLC), synchronous radiotherapy and chemotherapy is the standard treatment mode. But for patients with progress in half a year, which means the second-line chemotherapy effect is not ideal for them. We observed the efficacy and safety of anlotinib hydrochloride combined with PD-1 blockade as the second-line treatment for those patients in this trial. Patients and Methods From January 2018 to December 2019, 57 patients with the progress of local advanced NSCLC treated with anlotinib plus PD-1 blockade until disease progression or intolerance as a result of adverse events. Patients have been assessed using computed tomography prior to treatment and during follow-up every 2 months until disease progression or death. The primary endpoint was objective response rate (ORR). The secondary endpoints included overall survival (OS), progression-free survival (PFS) and safety. Survival curves were created using the Kaplan–Meier method. Results 57 patients were enrolled. The median age was 64 years, and 61.4% of the patients were men. The ORR was 50.9% with a median OS time of 14 months and the 1-year OS rates and PFS rates were 81.8% and 33.3%, respectively. The patients with squamous cell carcinoma, no brain or liver metastases had longer PFS than patients with liver metastasis. When the PFS was calculated from the time of second treatment, the median PFS was 9 months. Most adverse events (AEs) were grade 1–3, one drug-related death was noted. Conclusion The expected outcome of this study is that anlotinib combined with PD-1 blockade has tolerable toxicity and better ORR, OS than second-line chemotherapy. The results may indicate additional treatment options for patients with progress of local advance NSCLC in half a year after standard treatment.

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Risk of Infection with Immune Checkpoint Inhibitors: A Systematic Review and Meta-analysis

Cited by 19 publications

References 61 publications

Pancreatic injury following immune checkpoint inhibitors: A systematic review and meta-analysis

Pancreatic injury following immune checkpoint inhibitors: A systematic review and meta-analysis

Current state and future opportunities in granulocyte colony-stimulating factor (G-CSF)

Anlotinib Hydrochloride and PD-1 Blockade as a Salvage Second-Line Treatment in Patients with Progress of Local Advanced Non-Small Cell Lung Cancer in Half a Year After Standard Treatment

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