[Immune-related Adverse Events Induced by ICIs in Advanced NSCLC: A Meta-analysis and Systematic Review]

Overview

Journal Zhongguo Fei Ai Za Zhi

Specialties Oncology
Pulmonary Medicine

Date 2020 Aug 6

PMID 32752580

Citations 4

Authors

Qiaoxi Qin

Jiajin Wang

Hong Wang

Affiliations

Soon will be listed here.

Abstract

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-cytotoxic T-lymphocyte-asscociated antigen 4 (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.

Citing Articles

Development and validation of the self-report symptom inventory of immune-related adverse events in patients with lung cancer.

Fan T, Zhu S, Wang H, Dong Y, Zhou Y, Song Y Asia Pac J Oncol Nurs. 2024; 11(12):100603.

PMID: 39641008 PMC: 11617387. DOI: 10.1016/j.apjon.2024.100603.

Future Prospects of Immunotherapy in Non-Small-Cell Lung Cancer Patients: Is There Hope in Other Immune Checkpoints Targeting Molecules?.

Krzyzanowska N, Wojas-Krawczyk K, Milanowski J, Krawczyk P Int J Mol Sci. 2022; 23(6).

PMID: 35328510 PMC: 8950480. DOI: 10.3390/ijms23063087.

Systematic evaluation of the prognostic and immunological role of PDLIM2 across 33 cancer types.

Zeng Y, Lin D, Gao M, Du G, Cai Y Sci Rep. 2022; 12(1):1933.

PMID: 35121770 PMC: 8817018. DOI: 10.1038/s41598-022-05987-1.

Treatment of steroid-resistant checkpoint inhibitor pneumonitis with pirfenidone: A case report.

Miao K, Xu Y, Xu W, Zhang Y, Xu Y, Tian X Thorac Cancer. 2021; 12(15):2214-2216.

PMID: 34145962 PMC: 8327698. DOI: 10.1111/1759-7714.13921.

References

BURDICK K, HAWK W . VITILIGO IN A CASE OF VACCINIA VIRUS-TREATED MELANOMA. Cancer. 1964; 17:708-12. DOI: 10.1002/1097-0142(196406)17:6<708::aid-cncr2820170604>3.0.co;2-3. View

Callahan M, Postow M, Wolchok J . Targeting T Cell Co-receptors for Cancer Therapy. Immunity. 2016; 44(5):1069-78. DOI: 10.1016/j.immuni.2016.04.023. View

Facchinetti F, Marabelle A, Rossi G, Soria J, Besse B, Tiseo M . Moving Immune Checkpoint Blockade in Thoracic Tumors beyond NSCLC. J Thorac Oncol. 2016; 11(11):1819-1836. DOI: 10.1016/j.jtho.2016.05.027. View

Paz-Ares L, Luft A, Vicente D, Tafreshi A, Gumus M, Mazieres J . Pembrolizumab plus Chemotherapy for Squamous Non-Small-Cell Lung Cancer. N Engl J Med. 2018; 379(21):2040-2051. DOI: 10.1056/NEJMoa1810865. View

Reynolds K, Thomas M, Dougan M . Diagnosis and Management of Hepatitis in Patients on Checkpoint Blockade. Oncologist. 2018; 23(9):991-997. PMC: 6192661. DOI: 10.1634/theoncologist.2018-0174. View

Borghaei H, Paz-Ares L, Horn L, Spigel D, Steins M, Ready N . Nivolumab versus Docetaxel in Advanced Nonsquamous Non-Small-Cell Lung Cancer. N Engl J Med. 2015; 373(17):1627-39. PMC: 5705936. DOI: 10.1056/NEJMoa1507643. View

Antonia S, Goldberg S, Balmanoukian A, Chaft J, Sanborn R, Gupta A . Safety and antitumour activity of durvalumab plus tremelimumab in non-small cell lung cancer: a multicentre, phase 1b study. Lancet Oncol. 2016; 17(3):299-308. PMC: 5500167. DOI: 10.1016/S1470-2045(15)00544-6. View

Langer C, Gadgeel S, Borghaei H, Papadimitrakopoulou V, Patnaik A, Powell S . 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. Lancet Oncol. 2016; 17(11):1497-1508. PMC: 6886237. DOI: 10.1016/S1470-2045(16)30498-3. View

Brahmer J, Reckamp K, Baas P, Crino L, Eberhardt W, Poddubskaya E . Nivolumab versus Docetaxel in Advanced Squamous-Cell Non-Small-Cell Lung Cancer. N Engl J Med. 2015; 373(2):123-35. PMC: 4681400. DOI: 10.1056/NEJMoa1504627. View

10.

Carbone D, Reck M, Paz-Ares L, Creelan B, Horn L, Steins M . First-Line Nivolumab in Stage IV or Recurrent Non-Small-Cell Lung Cancer. N Engl J Med. 2017; 376(25):2415-2426. PMC: 6487310. DOI: 10.1056/NEJMoa1613493. View

11.

Mok T, Wu Y, Kudaba I, Kowalski D, Cho B, Turna H . 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. Lancet. 2019; 393(10183):1819-1830. DOI: 10.1016/S0140-6736(18)32409-7. View

12.

Barlesi F, Vansteenkiste J, Spigel D, Ishii H, Garassino M, de Marinis F . Avelumab versus docetaxel in patients with platinum-treated advanced non-small-cell lung cancer (JAVELIN Lung 200): an open-label, randomised, phase 3 study. Lancet Oncol. 2018; 19(11):1468-1479. DOI: 10.1016/S1470-2045(18)30673-9. View

13.

Antonia S, Villegas A, Daniel D, Vicente D, Murakami S, Hui R . Durvalumab after Chemoradiotherapy in Stage III Non-Small-Cell Lung Cancer. N Engl J Med. 2017; 377(20):1919-1929. DOI: 10.1056/NEJMoa1709937. View

14.

Lynch T, Bondarenko I, Luft A, Serwatowski P, Barlesi F, Chacko R . 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. J Clin Oncol. 2012; 30(17):2046-54. DOI: 10.1200/JCO.2011.38.4032. View

15.

Herbst R, Baas P, Kim D, Felip E, Perez-Gracia J, Han J . Pembrolizumab versus docetaxel for previously treated, PD-L1-positive, advanced non-small-cell lung cancer (KEYNOTE-010): a randomised controlled trial. Lancet. 2015; 387(10027):1540-1550. DOI: 10.1016/S0140-6736(15)01281-7. View

16.

Horvat T, Adel N, Dang T, Momtaz P, Postow M, Callahan M . 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. J Clin Oncol. 2015; 33(28):3193-8. PMC: 5087335. DOI: 10.1200/JCO.2015.60.8448. View

17.

Topalian S, Sznol M, Mcdermott D, Kluger H, Carvajal R, Sharfman W . Survival, durable tumor remission, and long-term safety in patients with advanced melanoma receiving nivolumab. J Clin Oncol. 2014; 32(10):1020-30. PMC: 4811023. DOI: 10.1200/JCO.2013.53.0105. View

18.

Siegel R, Miller K, Jemal A . Cancer statistics, 2019. CA Cancer J Clin. 2019; 69(1):7-34. DOI: 10.3322/caac.21551. View

19.

Bot I, Blank C, Boogerd W, Brandsma D . Neurological immune-related adverse events of ipilimumab. Pract Neurol. 2013; 13(4):278-80. DOI: 10.1136/practneurol-2012-000447. View

20.

Reck M, Rodriguez-Abreu D, Robinson A, Hui R, Csoszi T, Fulop A . Pembrolizumab versus Chemotherapy for PD-L1-Positive Non-Small-Cell Lung Cancer. N Engl J Med. 2016; 375(19):1823-1833. DOI: 10.1056/NEJMoa1606774. View

[Immune-related Adverse Events Induced by ICIs in Advanced NSCLC: A Meta-analysis and Systematic Review]

[Immune-related Adverse Events Induced by ICIs in Advanced NSCLC: A Meta-analysis and Systematic Review]