PMID- 35530329
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 12
DP  - 2022
TI  - Immune Checkpoint Inhibitors in Acute Myeloid Leukemia: A Meta-Analysis.
PG  - 882531
LID - 10.3389/fonc.2022.882531 [doi]
LID - 882531
AB  - BACKGROUND: Experience with immune checkpoint inhibitors (ICIs) in the treatment 
      of acute myeloid leukemia (AML) is still limited and based on early clinical 
      trials, with no reported randomized clinical data. In this study, we reviewed the 
      available evidence on the use of ICIs, either in monotherapy or in combination 
      with other treatments, in different AML settings, including newly diagnosed AML, 
      relapsed or refractory (R/R) AML and maintenance treatment after allogeneic-HSCT 
      (allo-HSCT). MATERIALS AND METHODS: A systematic literature review was conducted 
      using PubMed electronic database as primary source to identify the studies 
      involving immune checkpoint inhibitors in first-line and R/R AML. We recorded 
      Overall Response (ORR), Complete Response (CR) and Complete Response with 
      incomplete count recovery (CRi) rates, overall survival (OS) and immune-related 
      adverse events >/= grade 3 (irAEs). Hereafter, we analyzed the overall profile of 
      these ICIs by performing a meta-analysis of the reported outcomes. RESULTS: A 
      total of 13 studies were identified where ICI was used in patients with AML. ORR 
      across these studies was 42% (IC95%, 31% - 54%) and CR/CRi was 33% (IC95%, 
      22%-45%). Efficacy was also assessed considering the AML setting (first-line vs. 
      relapsed/refractory) and results pointed to higher response rates in first-line, 
      compared to R/R. Mean overall survival was 8.9 months [median 8 months, (IC95%, 
      3.9 - 15.5)]. Differences between first line and R/R settings were observed, 
      since average overall survival in first line was 12.0 months, duplicating the OS 
      in R/R which was 7.3 months. Additionally, the most specific adverse events (AEs) 
      of these therapies are immune-related adverse events (irAEs), derived from their 
      inflammatory effects. Grade >/=3 irAEs rate was low and similar among studies [12% 
      (95%CI 8% - 16%)]. CONCLUSION: ICIs in combination with intensive chemotherapy, 
      hypomethylating agents or other targeted therapies are gaining interest in the 
      management of hematological malignancies such as AML. However, results obtained 
      from clinical trials are modest and limited by both, the type of design and the 
      clinical trial phase. Hopefully, the prospective study of these therapies in 
      late-stage development could help to identify patients who may benefit from ICI 
      therapy.
CI  - Copyright (c) 2022 Gomez-Llobell, Peleteiro Raindo, Climent Medina, Gomez Centurion 
      and Mosquera Orgueira.
FAU - Gomez-Llobell, Marina
AU  - Gomez-Llobell M
AD  - Hematology Department, Medical University General Hospital Gregorio Maranon, 
      Madrid, Spain.
FAU - Peleteiro Raindo, Andres
AU  - Peleteiro Raindo A
AD  - Health Research Institute of Santiago de Compostela (IDIS), Santiago de 
      Compostela, Spain.
AD  - Division of Hematology, Complexo Hospitalario Universitario de Santiago de 
      Compostela (CHUS) University Hospital of Santiago de Compostela (SERGAS), 
      Department of Hematology, Santiago de Compostela, Spain.
FAU - Climent Medina, Jose
AU  - Climent Medina J
AD  - A&P Lifescience Advisors, Madrid, Spain.
FAU - Gomez Centurion, Ignacio
AU  - Gomez Centurion I
AD  - Hematology Department, Medical University General Hospital Gregorio Maranon, 
      Madrid, Spain.
FAU - Mosquera Orgueira, Adrian
AU  - Mosquera Orgueira A
AD  - Health Research Institute of Santiago de Compostela (IDIS), Santiago de 
      Compostela, Spain.
AD  - Division of Hematology, Complexo Hospitalario Universitario de Santiago de 
      Compostela (CHUS) University Hospital of Santiago de Compostela (SERGAS), 
      Department of Hematology, Santiago de Compostela, Spain.
LA  - eng
PT  - Systematic Review
DEP - 20220421
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC9069679
OTO - NOTNLM
OT  - acute myeloid leukemia (AML)
OT  - Anti-CD47
OT  - Anti-CD70
OT  - Anti-CTLA-4
OT  - Anti-PD1
OT  - Anti-TIM-3
OT  - immune checkpoint inhibitors (ICIs)
OT  - meta-analysis
COIS- Author JCM was employed by A&P Lifescience Advisors. The remaining authors 
      declare that the research was conducted in the absence of any commercial or 
      financial relationships that could be construed as a potential conflict of 
      interest.
EDAT- 2022/05/10 06:00
MHDA- 2022/05/10 06:01
PMCR- 2022/01/01
CRDT- 2022/05/09 04:21
PHST- 2022/02/23 00:00 [received]
PHST- 2022/03/21 00:00 [accepted]
PHST- 2022/05/09 04:21 [entrez]
PHST- 2022/05/10 06:00 [pubmed]
PHST- 2022/05/10 06:01 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2022.882531 [doi]
PST - epublish
SO  - Front Oncol. 2022 Apr 21;12:882531. doi: 10.3389/fonc.2022.882531. eCollection 
      2022.