Immune-Related Adverse Events Predict the Efficacy of Immune Checkpoint Inhibitors in Lung Cancer Patients: A Meta-Analysis.
Immune-Related Adverse Events Predict the Efficacy of Immune Checkpoint Inhibitors in Lung Cancer Patients: A Meta-Analysis.
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DOI：
10.3389/fonc.2021.631949
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发表时间：
2021
影响因子：
4.7
通讯作者：
Zhang F
中科院分区：
文献类型：
--
作者：
Wang D;Chen C;Gu Y;Lu W;Zhan P;Liu H;Lv T;Song Y;Zhang F
据报道，免疫相关不良事件（irAE）与免疫治疗的疗效相关。在此，我们进行了一项荟萃分析，以证明irAE可以预测免疫检查点抑制剂（ICI）在肺癌患者中的疗效。检索肺癌患者irAE与免疫治疗疗效相关性的文献，收集患者的客观缓解率（ORR）、总生存期（OS）或无进展生存期（PFS）数据。这些数据被纳入荟萃分析。本研究共检查了34份记录，包括8，115名患者。irAE的发生与较高的ORR {风险比（RR）：2.43，95%置信区间（CI）[2.06-2.88]，p < 0.00001}和改善的OS {风险比（HR）：0.51，95% CI [0.43-0.61]，p < 0.00001}和PFS显著相关。（HR：0.50，95% CI [0.44-0.57]，p < 0.00001）。亚组分析显示，发生皮肤病的患者OS显著延长，（OS：HR：0.53，95%CI [0.42-0.65]，p < 0.00001），内分泌（OS：HR：0.55，95%CI [0.45-0.67]，p < 0.00001）和胃肠道irAE（OS：HR：0.58，95%CI [0.42-0.80]，p = 0.0009）。然而，肝胆、肺和高级别（≥3）irAE与OS和PFS增加无关。肺癌患者中irAE的发生，特别是皮肤病、内分泌和胃肠道irAE，是ICI疗效增强的预测因子。
Immune-related adverse events (irAEs) have been reported to be associated with the efficacy of immunotherapy. Herein, we conducted a meta-analysis to demonstrate that irAEs could predict the efficacy of immune checkpoint inhibitors (ICIs) in lung cancer patients. Literature on the correlation between irAEs and the efficacy of immunotherapy in lung cancer patients were searched to collect the data on objective response rate (ORR), overall survival (OS), or progression-free survival (PFS) of the patients. These data were incorporated into the meta-analysis. A total of 34 records encompassing 8,115 patients were examined in this study. The irAEs occurrence was significantly associated with higher ORR {risk ratio (RR): 2.43, 95% confidence interval (CI) [2.06–2.88], p < 0.00001} and improved OS {hazard ratio (HR): 0.51, 95% CI [0.43–0.61], p < 0.00001}, and PFS (HR: 0.50, 95% CI [0.44–0.57], p < 0.00001) in lung cancer patients undergoing ICIs. Subgroup analysis revealed that OS was significantly longer in patients who developed dermatological (OS: HR: 0.53, 95%CI [0.42–0.65], p < 0.00001), endocrine (OS: HR: 0.55, 95%CI [0.45–0.67], p < 0.00001), and gastrointestinal irAEs (OS: HR: 0.58, 95%CI [0.42–0.80], p = 0.0009) than in those who did not. However, hepatobiliary, pulmonary, and high-grade (≥3) irAEs were not correlated with increased OS and PFS. The occurrence of irAEs in lung cancer patients, particularly dermatological, endocrine, and gastrointestinal irAEs, is a predictor of enhanced ICIs efficacy.
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影响因子：
3.1
作者：
Bjornhart, Birgitte;Hansen, Karin H.;Schytte, Tine
通讯作者：
Schytte, Tine
影响因子：
50.3
作者：
Hellmann MD;Callahan MK;Awad MM;Calvo E;Ascierto PA;Atmaca A;Rizvi NA;Hirsch FR;Selvaggi G;Szustakowski JD;Sasson A;Golhar R;Vitazka P;Chang H;Geese WJ;Antonia SJ
通讯作者：
Antonia SJ
影响因子：
3.6
作者：
Ksienski, Doran;Wai, Elaine S.;Lesperance, Mary
通讯作者：
Lesperance, Mary
影响因子：
5.3
作者：
Baldini, Editta;Lunghi, Alice;Giannarelli, Diana
通讯作者：
Giannarelli, Diana
影响因子：
2.2
作者：
DerSimonian, Rebecca;Kacker, Raghu
通讯作者：
Kacker, Raghu