PMID- 36825025
OWN - NLM
STAT- MEDLINE
DCOM- 20230227
LR  - 20230307
IS  - 1664-3224 (Electronic)
IS  - 1664-3224 (Linking)
VI  - 14
DP  - 2023
TI  - The safety of combining immune checkpoint inhibitors and platinum-based 
      chemotherapy for the treatment of solid tumors: A systematic review and network 
      meta-analysis.
PG  - 1062679
LID - 10.3389/fimmu.2023.1062679 [doi]
LID - 1062679
AB  - OBJECTIVE: Combination treatment regimens consisting of both immune checkpoint 
      inhibitors (ICI) and chemotherapeutic agents have emerged as the standard of care 
      for a range of cancers. This network meta-analysis (NMA) examined the toxicity 
      profiles and safety rankings of these different ICI-based combination regimens. 
      METHODS: The PubMed, EMBASE, Web of Science, and Cochrane Library databases were 
      searched for all randomized controlled trials (RCTs) published as of March 1, 
      2022 comparing two or more treatment regimens in which at least one arm was 
      comprised of an ICI + platinum-based chemotherapeutic regimen. Treatment-related 
      adverse events (AEs) of any grade and AEs of grade 3 or higher were the primary 
      endpoints for this analysis, while specific AE types were secondary endpoints. 
      This NMA combined both direct and indirect comparisons when analyzing odds ratios 
      (ORs) and the surface under the cumulative ranking curve (SUCRA) for different 
      ICI-based treatment regimens. RESULTS: In total, 33 RCTs enrolling 19,012 cancer 
      patients were included in this NMA. Of the analyzed regimens, avelumab + 
      chemotherapy and camrelizumab + chemotherapy were associated with a significantly 
      greater risk of AEs of any grade relative to ipilimumab + chemotherapy, 
      durvalumab + chemotherapy, or pembrolizumab + chemotherapy. No significant 
      differences in the risk of AEs of grade 3 or higher were observed when comparing 
      different ICI regimens. Hepatotoxicity and pyrexia were the most common AEs 
      associated with atezolizumab + chemotherapy treatment. Ipilimumab + chemotherapy 
      was associated with a relatively higher risk of gastrointestinal and skin 
      toxicity. Skin toxicity and hypothyroidism were the major AEs associated with 
      nivolumab + chemotherapy. Fatigue and pneumonia were the most common AEs 
      respectively associated with sugemalimab + chemotherapy and pembrolizumab + 
      chemotherapy regimens. CONCLUSIONS: Of the evaluated regimens, camrelizumab + 
      chemotherapy and avelumab + chemotherapy were associated with significantly 
      higher rates of AEs of any grade, whereas durvalumab and sintilimab were 
      relatively safe PD-L1 and PD-1 inhibitors, respectively, when administered in 
      combination with platinum-based chemotherapy. However, none of the evaluated ICI 
      + chemotherapy regimens exhibited any differences with respect to the incidence 
      of grade 3 or higher AEs, offering guidance that may be of value in routine 
      clinical practice.
CI  - Copyright (c) 2023 Mei, Wang, Deng and Gong.
FAU - Mei, Ting
AU  - Mei T
AD  - Department of Thoracic Oncology, Cancer Center and State Key Laboratory of 
      Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
FAU - Wang, Ting
AU  - Wang T
AD  - Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
FAU - Deng, Qianyue
AU  - Deng Q
AD  - Department of Thoracic Oncology, Cancer Center and State Key Laboratory of 
      Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
FAU - Gong, Youling
AU  - Gong Y
AD  - Department of Thoracic Oncology, Cancer Center and State Key Laboratory of 
      Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20230207
PL  - Switzerland
TA  - Front Immunol
JT  - Frontiers in immunology
JID - 101560960
RN  - 0 (Antineoplastic Agents, Immunological)
RN  - 0 (Immune Checkpoint Inhibitors)
RN  - 0 (Ipilimumab)
RN  - 0 (sugemalimab)
RN  - 49DFR088MY (Platinum)
SB  - IM
MH  - Humans
MH  - *Antineoplastic Agents, Immunological/adverse effects/therapeutic use
MH  - *Immune Checkpoint Inhibitors/adverse effects/therapeutic use
MH  - Ipilimumab/adverse effects/therapeutic use
MH  - *Neoplasms/drug therapy
MH  - Network Meta-Analysis
MH  - *Platinum/therapeutic use
MH  - Randomized Controlled Trials as Topic
PMC - PMC9941623
OTO - NOTNLM
OT  - adverse events
OT  - chemotherapy
OT  - immune checkpoint inhibitors
OT  - network comparison
OT  - safety
COIS- The 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- 2023/02/25 06:00
MHDA- 2023/03/03 06:00
PMCR- 2023/01/01
CRDT- 2023/02/24 03:03
PHST- 2022/10/06 00:00 [received]
PHST- 2023/01/23 00:00 [accepted]
PHST- 2023/02/24 03:03 [entrez]
PHST- 2023/02/25 06:00 [pubmed]
PHST- 2023/03/03 06:00 [medline]
PHST- 2023/01/01 00:00 [pmc-release]
AID - 10.3389/fimmu.2023.1062679 [doi]
PST - epublish
SO  - Front Immunol. 2023 Feb 7;14:1062679. doi: 10.3389/fimmu.2023.1062679. 
      eCollection 2023.