Online citations, reference lists, and bibliographies.
← Back to Search

[Immune-related Adverse Events Induced By ICIs In Advanced NSCLC: A Meta-analysis And Systematic Review].

Qiaoxi Qin, J. Wang, H. Wang
Published 2020 · Medicine

Save to my Library
Download PDF
Analyze on Scholarcy
Share
BACKGROUND In recent years, immune checkpoint inhibitors (ICIs) have become a hot spot in cancer because of their remarkable survival benefits on non-small cell lung cancer (NSCLC) patients. However, the immune-related adverse events (ir-AEs) induced by ICIs have been frequently reported due to its specificity and severity. This article is to summarize and evaluate ir-AEs induced by ICIs. Hopefully it can provide guidance for advanced NSCLC patients treatment options, early recognition and management of ir-AEs. METHODS Randomized controlled trials (RCT) which involved ICIs in the treatment of advanced NSCLC were retrieved in the Cochrane Libraby, PubMed, EMBASE and other databases. The primary outcome includes the incidence, grade and organ specificity of ir-AEs. Relative risk (RR) was used as the effect size, which was expressed as 95% confidence interval (CI). The Stata 15.0 and RevMan 5.3 software are used to conduct the meta analysis. RESULTS A total of 17 RCTs were included. The ir-AEs were generally more than those in the traditional chemotherapy group. The risk and severity of ir-AEs induced by ICIs combined group were generally higher than that of ICI monotherapy, while the incidence of severe ir-AEs induced by ICIs combination therapy was similar to that of anti-CTLA-4 group. CONCLUSIONS ICIs have different toxicity profile compared with chemotherapy, and their immune-related toxicity is stronger than that of traditional chemotherapy. ICIs induced ir-AEs is organ-specific, and different ICI has specific immune-related toxicity profiles. As ICIs represent a new and distinct class of treatment for NSCLC, this article has systematically illustrated the efficacy and ir-AEs induced by ICIs, hopefully it can be useful for clinicians and patients to get a further understanding of ICIs, and facilitate early prediction, comprehensive diagnosis, and prompt management of ir-AEs by providing status reference and management suggestions, so that ICI can bring more benefit for advanced NSCLC patients.
This paper references
10.1126/science.aac4255
Commensal Bifidobacterium promotes antitumor immunity and facilitates anti–PD-L1 efficacy
Ayelet Sivan (2015)
Ipilimumab efficacy and safety in patients with advanced melanoma: a retrospective analysis of HLA subtype from four trials.
J. Wolchok (2010)
10.1016/j.jtho.2016.05.027
Moving Immune Checkpoint Blockade in Thoracic Tumors beyond NSCLC
F. Facchinetti (2016)
10.1210/jc.2017-00448
Pembrolizumab-Induced Thyroiditis: Comprehensive Clinical Review and Insights Into Underlying Involved Mechanisms
Danae A Delivanis (2017)
10.1056/NEJMoa1507643
Nivolumab versus Docetaxel in Advanced Nonsquamous Non-Small-Cell Lung Cancer.
H. Borghaei (2015)
10.21037/jtd.2018.04.61
Durvalumab after chemoradiotherapy in stage III non-small cell lung cancer.
P. Tomasini (2018)
10.1093/annonc/mdw640
Antibody-mediated thyroid dysfunction during T-cell checkpoint blockade in patients with non-small-cell lung cancer
J. C. Osorio (2017)
10.1016/S1470-2045(15)00544-6
Safety and antitumour activity of durvalumab plus tremelimumab in non-small cell lung cancer: a multicentre, phase 1b study.
S. Antonia (2016)
10.1001/jamaneurol.2014.4103
A genome-wide association study of myasthenia gravis.
A. Renton (2015)
Yervoy ( Ipilimumab ) , immune - mediated adverse reaction management guide
JS Weber (2011)
10.1016/S1470-2045(16)30498-3
Carboplatin and pemetrexed with or without pembrolizumab for advanced, non-squamous non-small-cell lung cancer: a randomised, phase 2 cohort of the open-label KEYNOTE-021 study.
C. Langer (2016)
10.3322/canjclin.39.6.399
Cancer statistics
N. Dubrawsky (1989)
10.1016/S0140-6736(15)01281-7
Pembrolizumab versus docetaxel for previously treated, PD-L1-positive, advanced non-small-cell lung cancer (KEYNOTE-010): a randomised controlled trial
R. Herbst (2016)
10.1200/JCO.2016.71.7629
Phase III Trial of Ipilimumab Combined With Paclitaxel and Carboplatin in Advanced Squamous Non-Small-Cell Lung Cancer.
R. Govindan (2017)
10.1002/cncr.27969
Patterns of onset and resolution of immune‐related adverse events of special interest with ipilimumab
J. Weber (2013)
10.1200/JCO.2015.60.8448
Immune-Related Adverse Events, Need for Systemic Immunosuppression, and Effects on Survival and Time to Treatment Failure in Patients With Melanoma Treated With Ipilimumab at Memorial Sloan Kettering Cancer Center.
Troy Z. Horvat (2015)
10.1634/theoncologist.2018-0174
Diagnosis and Management of Hepatitis in Patients on Checkpoint Blockade
K. Reynolds (2018)
Anti-CTLA4 Antibody-Induced Lupus Nephritis
V. Sepe (2009)
Management of immunerelated adverse events in patients treated with immune checkpoint inhibitor therapy: american society of clinical oncology clinical practice guideline
J R Brahmer (2018)
10.1097/01.COT.0000525227.51402.C5
First-Line Nivolumab in Stage IV or Recurrent Non-Small Cell Lung Cancer
D. Carbone (2017)
10.1056/NEJMoa1910231
Nivolumab plus Ipilimumab in Advanced Non-Small-Cell Lung Cancer.
Matthew D. Hellmann (2019)
10.1016/S0140-6736(16)00587-0
Atezolizumab versus docetaxel for patients with previously treated non-small-cell lung cancer (POPLAR): a multicentre, open-label, phase 2 randomised controlled trial
L. Fehrenbacher (2016)
10.1016/S1470-2045(18)30673-9
Avelumab versus docetaxel in patients with platinum-treated advanced non-small-cell lung cancer (JAVELIN Lung 200): an open-label, randomised, phase 3 study.
F. Barlési (2018)
10.1136/practneurol-2012-000447
Neurological immune-related adverse events of ipilimumab
I. Bot (2013)
10.1200/JCO.2013.53.0105
Survival, durable tumor remission, and long-term safety in patients with advanced melanoma receiving nivolumab.
S. Topalian (2014)
10.4292/wjgpt.v10.i1.29
Ipilimumab and Nivolumab induced steroid-refractory colitis treated with infliximab: A case report
Ammar Nassri (2019)
10.1093/annonc/mdw443
Anti-PD-1 therapy in patients with advanced melanoma and preexisting autoimmune disorders or major toxicity with ipilimumab
A. Menzies (2017)
10.1007/s10620-008-0641-z
Cytotoxic T-Lymphocyte-Associated Antigen 4 Antibody-Induced Colitis and Its Management with Infliximab
R. Johnston (2008)
10.1016/J.YONC.2012.07.009
Ipilimumab in Combination With Paclitaxel and Carboplatin As First-Line Treatment in Stage IIIB/IV Non–Small-Cell Lung Cancer: Results From a Randomized, Double-Blind, Multicenter Phase II Study
A. Tsao (2012)
10.1016/j.jtho.2019.01.006
Nivolumab Versus Docetaxel in a Predominantly Chinese Patient Population With Previously Treated Advanced NSCLC: CheckMate 078 Randomized Phase III Clinical Trial
Y. Wu (2019)
10.1097/JTO.0000000000000630
The 2015 World Health Organization Classification of Lung Tumors: Impact of Genetic, Clinical and Radiologic Advances Since the 2004 Classification.
W. Travis (2015)
10.1158/1078-0432.CCR-07-0187
Prognostic Factors Related to Clinical Response in Patients with Metastatic Melanoma Treated by CTL-Associated Antigen-4 Blockade
Stephanie G Downey (2007)
10.3410/F.725757738.793528485
Faculty Opinions recommendation of The 2015 world health organization classification of lung tumors: impact of genetic, clinical and radiologic advances since the 2004 classification.
P. Schil (2017)
10.1126/science.aad1329
Anticancer immunotherapy by CTLA-4 blockade relies on the gut microbiota
M. Vétizou (2015)
10.1056/NEJMOA1606774
Pembrolizumab versus Chemotherapy for PD-L1-Positive Non-Small-Cell Lung Cancer.
M. Reck (2016)
10.1016/j.immuni.2016.04.023
Targeting T Cell Co-receptors for Cancer Therapy.
M. Callahan (2016)
10.1158/2326-6066.CIR-15-0267
Anti–PD-1 Inhibitor–Related Pneumonitis in Non–Small Cell Lung Cancer
M. Nishino (2016)
Ipilimumab), immune-mediated adverse reaction management guide
S Bristol-Myers (2011)
10.1016/j.ejca.2018.12.012
Immunotherapy comes of age in octagenarian and nonagenarian metastatic melanoma patients.
Guy Ben-Betzalel (2019)
10.1056/NEJMoa1504627
Nivolumab versus Docetaxel in Advanced Squamous-Cell Non-Small-Cell Lung Cancer.
J. Brahmer (2015)
10.1056/NEJMoa1801005
Pembrolizumab plus Chemotherapy in Metastatic Non–Small‐Cell Lung Cancer
L. Gandhi (2018)
10.1002/1097-0142(196406)17:6<708::AID-CNCR2820170604>3.0.CO;2-3
Vitiligo in a case of vaccinia virus‐treated melanoma
K. Burdick (1964)
Immune-related Adverse Events Induced by ICIs in Advanced NSCLC: A Meta-analysis and Systematic Review
Q X Qin
10.1016/S0140-6736(16)32517-X
Atezolizumab versus docetaxel in patients with previously treated non-small-cell lung cancer (OAK): a phase 3, open-label, multicentre randomised controlled trial
A. Rittmeyer (2017)
10.1056/NEJMoa1810865
Pembrolizumab plus Chemotherapy for Squamous Non–Small‐Cell Lung Cancer
L. Paz-Ares (2018)
10.3322/caac.21551
Cancer statistics, 2019
R. Siegel (2019)
10.1016/S0140-6736(18)32409-7
Pembrolizumab versus chemotherapy for previously untreated, PD-L1-expressing, locally advanced or metastatic non-small-cell lung cancer (KEYNOTE-042): a randomised, open-label, controlled, phase 3 trial
T. Mok (2019)



Semantic Scholar Logo Some data provided by SemanticScholar