O Abdel-Rahman1, D Helbling2, J Schmidt3, U Petrausch4, A Giryes2, A Mehrabi5, O Schöb3, M Mannhart6, H Oweira7. 1. Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt; OncoCentrum Zurich, Gastrointestinal Tumor Center Zurich (GITZ), Zurich, Switzerland. Electronic address: omar.abdelrhman@med.asu.edu.eg. 2. OncoCentrum Zurich, Gastrointestinal Tumor Center Zurich (GITZ), Zurich, Switzerland. 3. Surgical Center Zurich, Hirslanden Hospital, Zurich, Switzerland. 4. OncoCentrum Zurich, Swiss Tumor Immunology Institute (SwissTII), Zurich, Switzerland. 5. Department of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany. 6. Department of Oncology, Center of Zug, Switzerland. 7. Surgical Center Zurich, Hirslanden Hospital, Zurich, Switzerland; Department of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany.
Abstract
AIMS: We carried out a meta-analysis to determine the risk of treatment-related death associated with immune checkpoint inhibitor use in cancer patients. MATERIALS AND METHODS: We examined data from the Medline and Google Scholar databases. We also examined original studies and review articles for cross-references. Eligible studies included randomised phase II and phase III trials of patients with cancer treated with ipilimumab, pembrolizumab; nivolumab; tremelimumab and atezolizumab. The authors extracted relevant information on participants, characteristics, treatment-related death and information on the methodology of the studies. RESULTS: After exclusion of ineligible records, 18 clinical trials were included in the analysis. The odds ratio for treatment-related death for CTLA-4 inhibitors (ipilimumab and tremelimumab) was 1.80 (95% confidence interval 1.25, 2.59; P=0.002) and for PD-1/PD-L1 inhibitors (nivolumab, pembrolizumab and atezolizumab) was 0.63 (95% confidence interval 0.31, 1.30; P=0.22). Treated cancer seems to have no effect on the risk of treatment-related death. CONCLUSIONS: Analysis of our data showed that CTLA-4 inhibitors (ipilimumab and tremelimumab) in a higher dose (10 mg/kg) seem to be associated with a higher risk of treatment-related death compared with control regimens, whereas PD-1/PD-L1 inhibitors (nivolumab, pembrolizumab and atezolizumab) do not cause the same risk. Clinicians have to be fully aware of these differential risks and council their patients appropriately.
AIMS: We carried out a meta-analysis to determine the risk of treatment-related death associated with immune checkpoint inhibitor use in cancerpatients. MATERIALS AND METHODS: We examined data from the Medline and Google Scholar databases. We also examined original studies and review articles for cross-references. Eligible studies included randomised phase II and phase III trials of patients with cancer treated with ipilimumab, pembrolizumab; nivolumab; tremelimumab and atezolizumab. The authors extracted relevant information on participants, characteristics, treatment-related death and information on the methodology of the studies. RESULTS: After exclusion of ineligible records, 18 clinical trials were included in the analysis. The odds ratio for treatment-related death for CTLA-4 inhibitors (ipilimumab and tremelimumab) was 1.80 (95% confidence interval 1.25, 2.59; P=0.002) and for PD-1/PD-L1 inhibitors (nivolumab, pembrolizumab and atezolizumab) was 0.63 (95% confidence interval 0.31, 1.30; P=0.22). Treated cancer seems to have no effect on the risk of treatment-related death. CONCLUSIONS: Analysis of our data showed that CTLA-4 inhibitors (ipilimumab and tremelimumab) in a higher dose (10 mg/kg) seem to be associated with a higher risk of treatment-related death compared with control regimens, whereas PD-1/PD-L1 inhibitors (nivolumab, pembrolizumab and atezolizumab) do not cause the same risk. Clinicians have to be fully aware of these differential risks and council their patients appropriately.
Authors: Bradley M Haverkos; Diana Abbott; Mehdi Hamadani; Philippe Armand; Mary E Flowers; Reid Merryman; Manali Kamdar; Abraham Sebastian Kanate; Ayman Saad; Amitkumar Mehta; Siddhartha Ganguly; Timothy S Fenske; Parameswaran Hari; Robert Lowsky; Leslie Andritsos; Madan Jagasia; Asad Bashey; Stacey Brown; Veronika Bachanova; Deborah Stephens; Shin Mineishi; Ryotaro Nakamura; Yi-Bin Chen; Bruce R Blazar; Jonathan Gutman; Steven M Devine Journal: Blood Date: 2017-05-03 Impact factor: 22.113
Authors: David Pérez-Callejo; María Torrente; María Auxiliadora Brenes; Beatriz Núñez; Mariano Provencio Journal: Med Oncol Date: 2017-08-09 Impact factor: 3.064