PMID- 34883352
OWN - NLM
STAT- MEDLINE
DCOM- 20220324
LR  - 20220324
IS  - 1878-1705 (Electronic)
IS  - 1567-5769 (Linking)
VI  - 102
DP  - 2022 Jan
TI  - Adverse events of immunotherapy in non-small cell lung cancer: A systematic 
      review and network meta-analysis.
PG  - 108353
LID - S1567-5769(21)00989-9 [pii]
LID - 10.1016/j.intimp.2021.108353 [doi]
AB  - BACKGROUND: Immune checkpoint inhibitors have yielded significant treatment 
      progress in non-small cell lung cancer (NSCLC), while some special adverse events 
      (AEs) named immune-related adverse events (irAEs) were observed in clinical 
      trials. We aimed to systematically assess the incidences of AEs in immunotherapy 
      of NSCLC. METHODS: We searched randomized controlled trials (RCTs) in 
      PubMed/MEDLINE, Embase, Cochrane, and ClinicalTrail.gov before May 2021, and 
      grouped arms into 10 treatment categories. We extracted AEs as serious (grade 
      3-5) or others (grade1-2) from all systems, and we pooled their incidences by 
      random effects model. For arm-based pair-wise comparisons, we employed Bayesian 
      network meta-analysis. Meta-regression was used to assess the contribution of 
      coefficients. RESULTS: Totally 23,322 patients from 52 RCTs were included. The 
      overall incidences of serious AEs were 37.0% in chemotherapy arm, 33.0% in PD1 
      arm, and 37.0% in PDL1 arm, while in combined groups it was 47.0% in PDL1_Chemo 
      arm, 43.0% in PD1_CTLA4 arm, and 48.0% in ICI_Target arm. The incidence of each 
      serious AE was less than 4% in monotherapy, and slightly higher in combined 
      groups. In network meta-analysis, the immunotherapeutic groups presented a 
      significant higher incidence rank in colitis, hepatobiliary disorders, 
      pneumonitis, and rash compared with chemotherapy. There was a significantly 
      positive correlation between the occurrence of serious hepatitis (p < 0.0001) and 
      PFS in PDL1 arm, likewise serious pneumonitis (p = 0.0049) and rash (p < 0.0001) 
      in PD1 arm. CONCLUSIONS: The overall incidences of AEs were similar in immune 
      monotherapy compared with chemotherapy in NSCLC. Some irAEs were more common in 
      immune therapy and their frequencies were positively associated with clinical 
      efficacy.
CI  - Copyright (c) 2021 The Authors. Published by Elsevier B.V. All rights reserved.
FAU - Zhou, Chunyang
AU  - Zhou C
AD  - Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; 
      Shandong Cancer Hospital and Institute, Shandong First Medical University and 
      Shandong Academy of Medical Sciences, Jinan 250117, China.
FAU - Li, Minghao
AU  - Li M
AD  - Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; 
      Shandong Cancer Hospital and Institute, Shandong First Medical University and 
      Shandong Academy of Medical Sciences, Jinan 250117, China.
FAU - Wang, Zijian
AU  - Wang Z
AD  - Shandong Cancer Hospital and Institute, Shandong First Medical University and 
      Shandong Academy of Medical Sciences, Jinan 250117, China.
FAU - An, Dianzheng
AU  - An D
AD  - Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; 
      Shandong Cancer Hospital and Institute, Shandong First Medical University and 
      Shandong Academy of Medical Sciences, Jinan 250117, China.
FAU - Li, Baosheng
AU  - Li B
AD  - Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; 
      Shandong Cancer Hospital and Institute, Shandong First Medical University and 
      Shandong Academy of Medical Sciences, Jinan 250117, China. Electronic address: 
      bsli@sdfmu.edu.cn.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20211206
PL  - Netherlands
TA  - Int Immunopharmacol
JT  - International immunopharmacology
JID - 100965259
RN  - 0 (Antineoplastic Agents, Immunological)
SB  - IM
MH  - Antineoplastic Agents, Immunological/*adverse effects
MH  - Carcinoma, Non-Small-Cell Lung/*drug therapy
MH  - Humans
MH  - Immunotherapy/*adverse effects
MH  - Lung Neoplasms/*drug therapy
MH  - Network Meta-Analysis
MH  - Randomized Controlled Trials as Topic
OTO - NOTNLM
OT  - Immune checkpoint inhibitors
OT  - Immune combined therapy
OT  - Immune-related adverse events
OT  - Non-small cell lung cancer
OT  - Pneumonitis
EDAT- 2021/12/10 06:00
MHDA- 2022/03/25 06:00
CRDT- 2021/12/09 20:21
PHST- 2021/08/02 00:00 [received]
PHST- 2021/10/10 00:00 [revised]
PHST- 2021/11/05 00:00 [accepted]
PHST- 2021/12/10 06:00 [pubmed]
PHST- 2022/03/25 06:00 [medline]
PHST- 2021/12/09 20:21 [entrez]
AID - S1567-5769(21)00989-9 [pii]
AID - 10.1016/j.intimp.2021.108353 [doi]
PST - ppublish
SO  - Int Immunopharmacol. 2022 Jan;102:108353. doi: 10.1016/j.intimp.2021.108353. Epub 
      2021 Dec 6.