S'abonner

Comprehensive analysis of treatment-related adverse events of immunotherapy in advanced gastric or gastroesophageal junction cancer: A meta-analysis of randomized controlled trials - 24/11/22

Doi : 10.1016/j.clinre.2022.102031 
Hang Yuan a, Dan-Dan Duan b, Ya-Jun Zhang a,
a Department of Pharmacy, The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, 24 Jinghua Road, Jianxi District, Luoyang 471003, China 
b Henan Provincial Corps Hospital of Chinese People's Armed Police Force, Zhengzhou 450000, China 

Corresponding author.

Highlights

The risk of treatment-related adverse events (TRAEs) in advanced gastric or gastroesophageal junction cancer (AG/GEJC) with immunotherapy has not adequately assessed, and it remains uncertain whether there is an increased risk of TRAEs owing to immune checkpoint inhibitors (ICIs).
Immunotherapy did not have a significantly increased risk experiencing any type of TRAEs.
ICIs had a more manageable safety profile than chemotherapy.
CTLA-4 inhibitors were associated with higher risk of TRAEs compared PD-1/PD-L1 inhibitors.

Le texte complet de cet article est disponible en PDF.

Abstract

Aims

Immune checkpoint inhibitors (ICIs) have been recognized as an effective treatment for advanced gastric or gastroesophageal junction cancer (AG/GEJC). However, the safety of ICIs in patients has not been established. We aimed to systematically assess the risk of all common treatment-related adverse events (TRAEs) in immunotherapy of AG/GEJC.

Methods

A systematic search of randomized controlled trials (RCTs) published until May 2022 was performed using PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials. And a meta‐analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) statement.

Results

A total of nine RCTs, including 2918 patients, met the eligibility criteria. The pooled overall incidences of all grade TRAEs, grade 3 or higher TRAEs and treatment-related death were 54.5% (95% confidence interval [CI]: 48.7%–60.2%, I2=75.55%), 12.8% (95% CI: 10.2%–15.7%, I2=51.61%) and 0.11% (95% CI: 0.00%–0.51%, I2=1.63%). Subgroup analyses showed that CTLA-4 inhibitors had a higher risk of any type of TRAEs, when compared with PD-1 and PD-L1 inhibitors. Meta-regression showed significant correlation between all grade TRAEs and proportion of female. Fatigue and diarrhoea were involved in common TRAEs.

Conclusions

Our study provides a comprehensive overview of ICIs-associated AEs in AG/GEJC. Immunotherapy did not have a significantly increased risk experiencing any type of TRAEs, and ICIs had a more manageable safety profile than chemotherapy. These findings provide important guidance to clinicians in counseling and management of patients with AG/GEJC.

Le texte complet de cet article est disponible en PDF.

Keywords : Immune checkpoint inhibitors, Immunotherapy, Adverse events, Advanced gastric or gastroesophageal junction cancer, Meta-analysis

Abbreviations : AE, AG/GEJC, AST, ALT, BSC, CTLA-4, CTCAE, ECOG, G/GEJC, ICIs, NA, 95% CI, PD‐L1, PD‐1, RCTs, RR, TRAEs


Plan


© 2022  Elsevier Masson SAS. Tous droits réservés.
Ajouter à ma bibliothèque Retirer de ma bibliothèque Imprimer
Export

    Export citations

  • Fichier

  • Contenu

Vol 46 - N° 10

Article 102031- décembre 2022 Retour au numéro
Article précédent Article précédent
  • Impact of metabolic syndrome on the short- and long-term outcomes for the elderly patients with gastric cancer after radical gastrectomy
  • He Wu, Hao-Jie Jiang, Su-Lin Wang, Xi-Yi Chen, Liang-Liang Ma, Zhen Yu, Chong-Jun Zhou
| Article suivant Article suivant
  • COVID-19-associated secondary sclerosing cholangitis – A case series of 4 patients
  • Filipa Bordalo Ferreira, Margarida Mourato, Sofia Bragança, Joana Batista Paulo, Rita Sismeiro, André Pereira, Ana Nassauer Mónica, Luís Carvalho Lourenço, Mariana Cardoso

Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.

Déjà abonné à cette revue ?

Mon compte


Plateformes Elsevier Masson

Déclaration CNIL

EM-CONSULTE.COM est déclaré à la CNIL, déclaration n° 1286925.

En application de la loi nº78-17 du 6 janvier 1978 relative à l'informatique, aux fichiers et aux libertés, vous disposez des droits d'opposition (art.26 de la loi), d'accès (art.34 à 38 de la loi), et de rectification (art.36 de la loi) des données vous concernant. Ainsi, vous pouvez exiger que soient rectifiées, complétées, clarifiées, mises à jour ou effacées les informations vous concernant qui sont inexactes, incomplètes, équivoques, périmées ou dont la collecte ou l'utilisation ou la conservation est interdite.
Les informations personnelles concernant les visiteurs de notre site, y compris leur identité, sont confidentielles.
Le responsable du site s'engage sur l'honneur à respecter les conditions légales de confidentialité applicables en France et à ne pas divulguer ces informations à des tiers.


Tout le contenu de ce site: Copyright © 2024 Elsevier, ses concédants de licence et ses contributeurs. Tout les droits sont réservés, y compris ceux relatifs à l'exploration de textes et de données, a la formation en IA et aux technologies similaires. Pour tout contenu en libre accès, les conditions de licence Creative Commons s'appliquent.