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Immune-related serious adverse events with immune checkpoint inhibitors: Systematic review and network meta-analysis.


ABSTRACT:

Purpose

Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment, though uncertainty exists regarding their immune-related safety. The objective of this study was to assess the comparative safety profile (odds ratio) of ICIs and estimate the absolute rate of immune-related serious adverse events (irSAEs) in cancer patients undergoing treatment with ICIs.

Methods

We searched for randomized trials till February 2021, including all ICIs for all cancers. Primary outcome was overall irSAEs, and secondary outcomes were pneumonitis, colitis, hepatitis, hypophysitis, myocarditis, nephritis, and pancreatitis. We conducted Bayesian network meta-analyses, estimated absolute rates and ranked treatments according to the surface under the cumulative ranking curve (SUCRA).

Results

We included 96 trials (52,811 participants, median age 62 years). Risk of bias was high in most trials. Most cancers were non-small cell lung cancer (28 trials) and melanoma (15 trials). The worst-ranked ICI was ipilimumab (SUCRA 14%; event rate 848/10,000 patients) while the best-ranked ICI was atezolizumab (SUCRA 82%; event rate 119/10,000 patients).

Conclusion

Each ICI showed a unique safety profile, with certain events more frequently observed with specific ICIs, which should be considered when managing cancer patients.

SUBMITTER: Oliveira C 

PROVIDER: S-EPMC11001692 | biostudies-literature | 2024 May

REPOSITORIES: biostudies-literature

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Immune-related serious adverse events with immune checkpoint inhibitors: Systematic review and network meta-analysis.

Oliveira Clara C   Mainoli Beatrice B   Duarte Gonçalo S GS   Machado Tiago T   Tinoco Rita G RG   Esperança-Martins Miguel M   Ferreira Joaquim J JJ   Costa João J  

European journal of clinical pharmacology 20240219 5


<h4>Purpose</h4>Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment, though uncertainty exists regarding their immune-related safety. The objective of this study was to assess the comparative safety profile (odds ratio) of ICIs and estimate the absolute rate of immune-related serious adverse events (irSAEs) in cancer patients undergoing treatment with ICIs.<h4>Methods</h4>We searched for randomized trials till February 2021, including all ICIs for all cancers. Primary outcom  ...[more]

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