PMID- 37359551
OWN - NLM
STAT- MEDLINE
DCOM- 20230628
LR  - 20230701
IS  - 1664-3224 (Electronic)
IS  - 1664-3224 (Linking)
VI  - 14
DP  - 2023
TI  - Pancreatic adverse events of immune checkpoint inhibitors therapy for solid 
      cancer patients: a systematic review and meta-analysis.
PG  - 1166299
LID - 10.3389/fimmu.2023.1166299 [doi]
LID - 1166299
AB  - OBJECTIVE: This review aims to determine the incidence and risk of pancreatic 
      adverse events (AEs) associated with immune checkpoint inhibitors (ICIs) therapy 
      for solid tumors. METHODS: We conducted a comprehensive systematic literature 
      search in PubMed, Embase, and Cochrane Library up to March 15, 2023, to identify 
      all randomized controlled trials comparing ICIs with standard treatment in solid 
      tumors. We included studies that reported immune-related pancreatitis or 
      elevation of serum amylase or lipase levels. Following protocol registration in 
      PROSPERO, we conducted a systematic review and meta-analysis. RESULTS: 59 unique 
      randomized controlled trials with at least one ICI-containing arm (41 757 
      patients) were retrieved. The incidences for all-grade pancreatitis, amylase 
      elevation and lipase elevation were 0.93% (95% CI 0.77-1.13), 2.57% (95% CI 
      1.83-3.60) and 2.78% (95% CI 1.83-4.19), respectively. The incidences for grade 
      >/=3 pancreatitis, amylase elevation and lipase elevation were 0.68% (95% CI 
      0.54-0.85), 1.17% (95% CI 0.83-1.64) and 1.71% (95% CI 1.18-2.49), respectively. 
      The use of ICIs was associated with an increased risk of all-grade pancreatic 
      immune-related AEs (irAEs) including pancreatitis (OR=2.04, 95% CI 1.42-2.94, P 
      =0.0001), amylase elevation (OR=1.91, 95% CI 1.47-2.49, P < 0.0001) and lipase 
      elevation (OR=1.77, 95% CI 1.37-2.29, P < 0.0001). In addition to these, the 
      post-hoc analysis found that PD-1 inhibitors had a significant higher risk of 
      pancreatic AEs compared with PD-L1 inhibitors and the patients undergoing dual 
      ICI therapy were at a significantly higher risk of pancreatic AEs than the 
      patients receiving single ICI therapy. CONCLUSION: Our study provides an overview 
      of the incidence and risk of ICI-associated pancreatitis and pancreatic enzyme 
      elevations in the treatment of solid tumors. Our findings may help raise 
      awareness among clinicians of the potential for ICI-associated pancreatic AEs in 
      clinical practice. SYSTEMATIC REVIEW REGISTRATION: 
      https://www.crd.york.ac.uk/PROSPERO, identifier 345350.
CI  - Copyright (c) 2023 Zhao, Zhang, Pang, Zeng, Liu and Liu.
FAU - Zhao, Zhe
AU  - Zhao Z
AD  - Department of Oncology, Jinan Central Hospital, Shandong University, Jinan, 
      Shandong, China.
FAU - Zhang, Weike
AU  - Zhang W
AD  - Department of Oncology, Jinan Central Hospital, Shandong University, Jinan, 
      Shandong, China.
FAU - Pang, Longbin
AU  - Pang L
AD  - Pulmonary and Critical Care Medicine, Central Hospital Affiliated to Shandong 
      First Medical University, Jinan, Shandong, China.
FAU - Zeng, Liangjie
AU  - Zeng L
AD  - Department of Oncology, Central Hospital Affiliated to Shandong First Medical 
      University, Jinan, Shandong, China.
FAU - Liu, Surui
AU  - Liu S
AD  - Department of Oncology, Central Hospital Affiliated to Shandong First Medical 
      University, Jinan, Shandong, China.
FAU - Liu, Jie
AU  - Liu J
AD  - Department of Oncology, Jinan Central Hospital, Shandong University, Jinan, 
      Shandong, China.
AD  - Department of Oncology, Central Hospital Affiliated to Shandong First Medical 
      University, Jinan, Shandong, China.
LA  - eng
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20230609
PL  - Switzerland
TA  - Front Immunol
JT  - Frontiers in immunology
JID - 101560960
RN  - 0 (Immune Checkpoint Inhibitors)
RN  - EC 3.2.1.- (Amylases)
RN  - EC 3.1.1.3 (Lipase)
SB  - IM
MH  - Humans
MH  - Immune Checkpoint Inhibitors/adverse effects
MH  - *Pancreatitis/chemically induced/epidemiology
MH  - *Neoplasms/drug therapy
MH  - Amylases
MH  - Lipase
PMC - PMC10289552
OTO - NOTNLM
OT  - drug-related adverse events
OT  - immune checkpoint inhibitors
OT  - immunotherapy
OT  - meta - analysis
OT  - pancreatic adverse events
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- 2023/06/26 19:07
MHDA- 2023/06/28 06:42
PMCR- 2023/01/01
CRDT- 2023/06/26 12:25
PHST- 2023/02/15 00:00 [received]
PHST- 2023/05/30 00:00 [accepted]
PHST- 2023/06/28 06:42 [medline]
PHST- 2023/06/26 19:07 [pubmed]
PHST- 2023/06/26 12:25 [entrez]
PHST- 2023/01/01 00:00 [pmc-release]
AID - 10.3389/fimmu.2023.1166299 [doi]
PST - epublish
SO  - Front Immunol. 2023 Jun 9;14:1166299. doi: 10.3389/fimmu.2023.1166299. 
      eCollection 2023.