PMID- 36385419
OWN - NLM
STAT- MEDLINE
DCOM- 20231023
LR  - 20231023
IS  - 1591-9528 (Electronic)
IS  - 1591-8890 (Linking)
VI  - 23
IP  - 6
DP  - 2023 Oct
TI  - Adverse events of immune checkpoint inhibitors in hepatocellular carcinoma: a 
      systemic review and meta-analysis.
PG  - 2115-2129
LID - 10.1007/s10238-022-00938-6 [doi]
AB  - The introduction of immune checkpoint inhibitors (ICIs) has reshaped the therapy 
      of hepatocellular carcinoma (HCC). ICIs are a novel therapy with frequent adverse 
      events (AEs), including treatment-related adverse events (trAEs) and 
      immune-related adverse events (irAEs). However, no comprehensive overview of the 
      toxicity spectrum of ICIs in HCC patients has been provided. Electronic databases 
      were searched to identify eligible studies. A meta-analysis of the incidence rate 
      of AEs in HCC patients treated with ICIs was performed. Lastly, the prognostic 
      value of irAEs in HCC patients treated with ICIs was verified. Forty-seven 
      studies with 6472 participations met the inclusion criteria. The pooled all-grade 
      trAEs incidence rate was 83.4% (95% confidence interval [95% CI] 
      77.0-89.1%), >/= grade 3 trAEs incidence rate was 33.0% (95% CI 26.9-39.5%), 
      all-grade irAEs incidence rate was 34% (95% CI 22-47%), and >/= grade 3 irAEs 
      incidence rate was 9% (95% CI 5-14%). Aspartate aminotransferase (AST) increase 
      (38%, 95% CI 35-40%) is the most common trAEs. Fatigue (14%, 95% CI 7-23%) is the 
      most common irAEs. The pooled results also showed that 18.8% (95% CI 13.2-25.2%) 
      of patients required systemic steroid therapy due to AEs, while 6.6% (95% CI 
      4.6-9.0%) of patients withdrew from treatment due to AEs. Additionally, patients 
      experiencing irAEs may have a better progression-free survival (PFS) 
      (multivariate analysis: hazard ratio [HR] = 0.41, 95% CI 0.27-0.61, I(2) = 36.3%) 
      but not overall survival (OS) (multivariate analysis: HR = 0.54, 95% CI 
      0.22-1.36, I(2) = 83.2%) than those with no irAEs. Our study presents a systemic 
      assessment of the AEs profile in HCC patients receiving ICIs, providing important 
      reference for clinicians on toxicity profile. Besides, patients with irAEs may 
      have a better PFS. More large-scale and prospective studies are needed to 
      confirm our conclusions.
CI  - (c) 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.
FAU - Tian, Jin-Cheng
AU  - Tian JC
AD  - Department of General Surgery, Qilu Hospital of Shandong University, Jinan, 
      China.
FAU - Liu, Hui
AU  - Liu H
AD  - Department of General Surgery, Qilu Hospital of Shandong University, Jinan, 
      China.
FAU - Yan, Lun-Jie
AU  - Yan LJ
AD  - Department of General Surgery, Qilu Hospital of Shandong University, Jinan, 
      China.
FAU - Ding, Zi-Niu
AU  - Ding ZN
AD  - Department of General Surgery, Qilu Hospital of Shandong University, Jinan, 
      China.
FAU - Han, Cheng-Long
AU  - Han CL
AD  - Department of General Surgery, Qilu Hospital of Shandong University, Jinan, 
      China.
FAU - Tian, Bao-Wen
AU  - Tian BW
AD  - Department of General Surgery, Qilu Hospital of Shandong University, Jinan, 
      China.
FAU - Tan, Si-Yu
AU  - Tan SY
AD  - Department of General Surgery, Qilu Hospital of Shandong University, Jinan, 
      China.
FAU - Dong, Zhao-Ru
AU  - Dong ZR
AD  - Department of General Surgery, Qilu Hospital of Shandong University, Jinan, 
      China.
FAU - Wang, Dong-Xu
AU  - Wang DX
AD  - Department of General Surgery, Qilu Hospital of Shandong University, Jinan, 
      China.
FAU - Xue, Jun-Shuai
AU  - Xue JS
AD  - Department of General Surgery, Qilu Hospital of Shandong University, Jinan, 
      China.
FAU - Mao, Xin-Cheng
AU  - Mao XC
AD  - Department of General Surgery, Qilu Hospital of Shandong University, Jinan, 
      China.
FAU - Yan, Yu-Chuan
AU  - Yan YC
AD  - Department of General Surgery, Qilu Hospital of Shandong University, Jinan, 
      China.
FAU - Li, Tao
AU  - Li T
AD  - Department of Hepatobiliary Surgery, The Second Hospital of Shandong University, 
      No. 247 Beiyuan Street, Jinan, 250033, China. litao7706@163.com.
LA  - eng
GR  - 82073200 & 81874178/National Natural Science Foundation of China/
GR  - 2020GXRC023/Independent Cultivation of Innovative Team from Universities in 
      Jinan/
GR  - ZR202105070027/Major basic research of Shandong Provincial Natural Science 
      Foundation/
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20221116
PL  - Italy
TA  - Clin Exp Med
JT  - Clinical and experimental medicine
JID - 100973405
RN  - 0 (Immune Checkpoint Inhibitors)
RN  - EC 2.6.1.1 (Aspartate Aminotransferases)
SB  - IM
MH  - Humans
MH  - Immune Checkpoint Inhibitors/adverse effects
MH  - *Carcinoma, Hepatocellular/drug therapy
MH  - *Liver Neoplasms/drug therapy
MH  - Aspartate Aminotransferases
OTO - NOTNLM
OT  - Adverse events
OT  - Hepatocellular carcinoma
OT  - Immune checkpoint inhibitors
OT  - Incidence
OT  - Meta-analysis
OT  - Prognosis
EDAT- 2022/11/18 06:00
MHDA- 2023/10/23 12:42
CRDT- 2022/11/17 11:01
PHST- 2022/10/09 00:00 [received]
PHST- 2022/10/27 00:00 [accepted]
PHST- 2023/10/23 12:42 [medline]
PHST- 2022/11/18 06:00 [pubmed]
PHST- 2022/11/17 11:01 [entrez]
AID - 10.1007/s10238-022-00938-6 [pii]
AID - 10.1007/s10238-022-00938-6 [doi]
PST - ppublish
SO  - Clin Exp Med. 2023 Oct;23(6):2115-2129. doi: 10.1007/s10238-022-00938-6. Epub 
      2022 Nov 16.