PMID- 31912796
OWN - NLM
STAT- MEDLINE
DCOM- 20210106
LR  - 20220531
IS  - 1569-8041 (Electronic)
IS  - 0923-7534 (Linking)
VI  - 31
IP  - 1
DP  - 2020 Jan
TI  - Adverse event profile for immunotherapy agents compared with chemotherapy in 
      solid organ tumors: a systematic review and meta-analysis of randomized clinical 
      trials.
PG  - 50-60
LID - S0923-7534(19)35463-8 [pii]
LID - 10.1016/j.annonc.2019.10.008 [doi]
AB  - BACKGROUND: Immunotherapy agents are an innovative oncological treatment modality 
      and as a result their use has expanded widely. Understanding the 
      treatment-related adverse events (AEs) of these drugs compared with traditional 
      chemotherapy is crucial for clinical practice. DESIGN: A systematic review of 
      studies indexed in Medline (PubMed), Embase, Web of Science, and the Cochrane 
      Databases from January 2000 to 14 February 2019 was conducted. Randomized 
      clinical trials comparing immunotherapy [cytotoxic T-lymphocyte protein-4 
      (CTLA-4), programmed cell death protein 1 (PD-1), or programmed death-ligand 1 
      (PD-L1)] with standard-of-care chemotherapy in the treatment of advanced 
      solid-organ neoplasms were included if AEs were reported as an outcome. Primary 
      outcome was AEs >/= grade 3 in severity. Secondary outcomes were proportion of 
      overall AEs, treatment discontinuation due to AEs, deaths due to AEs, and 
      specific AEs [fatigue, diarrhea, acute kidney injury (AKI), colitis, pneumonitis, 
      and hypothyroidism]. Paule-Mandel pooling and a random effects model were used to 
      produce odds ratios (ORs) for measures of effects. RESULTS: Among 10 598 
      abstracts screened, we included 22 studies involving 12 727 patients. In the 
      immunotherapy group, 16.5% of patients developed an AE >/= grade 3 in severity, 
      compared with 41.09% in the chemotherapy arm [OR = 0.26, 95% confidence interval 
      (CI) 0.19-0.35, I(2) = 92%]. Patients receiving immunotherapy also had lower odds 
      of developing an AE overall (OR = 0.35, 95% CI 0.28-0.44; I(2) = 77%), 
      terminating therapy due to an AE (OR = 0.55, 95% CI 0.39-0.78, I(2) = 80%), or 
      dying from a treatment-related AE (OR = 0.67, 95% CI 0.46-0.98, I(2) = 0%). When 
      treated with chemotherapy versus immunotherapy, patients more frequently 
      experienced fatigue (25.10% versus 15.83%), diarrhea (14.97% versus 11.13%), and 
      AKI (1.79% versus 1.31%). However, colitis (1.02% versus 0.26%), pneumonitis 
      (3.36% versus 0.36%), and hypothyroidism (6.82% versus 0.37%) were more common in 
      those treated with immunotherapy. CONCLUSIONS: Treatment of advanced solid-organ 
      malignancies with immunotherapy compared with traditional chemotherapy is 
      associated with a lower risk of AEs.
CI  - Copyright (c) 2019 European Society for Medical Oncology. Published by Elsevier 
      Ltd. All rights reserved.
FAU - Magee, D E
AU  - Magee DE
AD  - Division of Urology, Department of Surgery, University of Toronto, Toronto, 
      Canada.
FAU - Hird, A E
AU  - Hird AE
AD  - Division of Urology, Department of Surgery, University of Toronto, Toronto, 
      Canada.
FAU - Klaassen, Z
AU  - Klaassen Z
AD  - Division of Urology, Department of Surgery, Medical College of Georgia-Augusta 
      University, Augusta, USA.
FAU - Sridhar, S S
AU  - Sridhar SS
AD  - Division of Medical Oncology, Department of Internal Medicine, University Health 
      Network, University of Toronto, Toronto, Canada.
FAU - Nam, R K
AU  - Nam RK
AD  - Division of Urology, Department of Surgery, Sunnybrook Health Sciences Centre, 
      University of Toronto, Toronto, Canada.
FAU - Wallis, C J D
AU  - Wallis CJD
AD  - Division of Urology, Department of Surgery, University of Toronto, Toronto, 
      Canada; Department of Urologic Surgery, Vanderbilt University Medical Center, 
      Nashville, USA.
FAU - Kulkarni, G S
AU  - Kulkarni GS
AD  - Division of Urology, Department of Surgery, University Health Network, University 
      of Toronto, Toronto, Canada. Electronic address: Girish.Kulkarni@uhn.ca.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
PL  - England
TA  - Ann Oncol
JT  - Annals of oncology : official journal of the European Society for Medical 
      Oncology
JID - 9007735
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Immunologic Factors)
SB  - IM
MH  - *Antineoplastic Agents/therapeutic use
MH  - Humans
MH  - Immunologic Factors/therapeutic use
MH  - Immunotherapy/adverse effects
MH  - *Neoplasms/drug therapy
MH  - Randomized Controlled Trials as Topic
OTO - NOTNLM
OT  - adverse events
OT  - chemotherapy
OT  - immunotherapy
OT  - meta-analysis
OT  - neoplasm
EDAT- 2020/01/09 06:00
MHDA- 2021/01/07 06:00
CRDT- 2020/01/09 06:00
PHST- 2019/07/18 00:00 [received]
PHST- 2019/10/15 00:00 [revised]
PHST- 2019/10/17 00:00 [accepted]
PHST- 2020/01/09 06:00 [entrez]
PHST- 2020/01/09 06:00 [pubmed]
PHST- 2021/01/07 06:00 [medline]
AID - S0923-7534(19)35463-8 [pii]
AID - 10.1016/j.annonc.2019.10.008 [doi]
PST - ppublish
SO  - Ann Oncol. 2020 Jan;31(1):50-60. doi: 10.1016/j.annonc.2019.10.008.