Safety evaluation of immune checkpoint inhibitors combined with chemotherapy for the treatment of small cell lung cancer: A meta‐analysis of randomized controlled trials
Abstract Background The addition of immune checkpoint inhibitors (ICIs) to chemotherapy is the new standard of care in the first‐line treatment of small cell lung cancer (SCLC). However, although the concomitant use of immunotherapy and chemotherapy can increase the antitumor efficacy, it can also i...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-04-01
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| Series: | Thoracic Cancer |
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| Online Access: | https://doi.org/10.1111/1759-7714.14842 |
| _version_ | 1827320167667859456 |
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| author | Vito Longo Alessandro Rizzo Annamaria Catino Michele Montrone Domenico Galetta |
| author_facet | Vito Longo Alessandro Rizzo Annamaria Catino Michele Montrone Domenico Galetta |
| author_sort | Vito Longo |
| collection | DOAJ |
| description | Abstract Background The addition of immune checkpoint inhibitors (ICIs) to chemotherapy is the new standard of care in the first‐line treatment of small cell lung cancer (SCLC). However, although the concomitant use of immunotherapy and chemotherapy can increase the antitumor efficacy, it can also increase toxicity. The present study evaluated the tolerability of immune‐based combinations in the first‐line treatment of SCLC. Methods Relevant trials were identified by searching electronic databases and conference meetings. Seven phase II and III randomized controlled trials and 3766 SCLC patients were included in the meta‐analysis (immune‐based combinations = 2133; chemotherapy = 1633). Outcomes of interest included treatment‐related adverse events (TRAEs) and the rate of discontinuation due to TRAEs. Results Immune‐based combination treatment was associated with a higher risk of grade 3–5 TRAEs (odds ratio [OR], 1.16; 95% confidence interval [CI]: 1.01–1.35). Immune‐based combinations were associated with a higher risk of TRAEs leading to discontinuation (OR, 2.30; 95% CI: 1.17–4.54). No differences were observed in grade 5 TRAEs (OR, 1.56; 95% CI: 0.93–2.63). Conclusion This meta‐analysis indicates that the addition of immunotherapy to chemotherapy in SCLC patients is associated with a higher risk of toxicity and probably of treatment discontinuation. Tools for identifying SCLC patients that would not benefit from immune‐based therapy are urgently needed. |
| first_indexed | 2024-04-25T00:41:00Z |
| format | Article |
| id | doaj.art-9ef74b05f8f34572a4c02b44979b9a7d |
| institution | Directory Open Access Journal |
| issn | 1759-7706 1759-7714 |
| language | English |
| last_indexed | 2024-04-25T00:41:00Z |
| publishDate | 2023-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Thoracic Cancer |
| spelling | doaj.art-9ef74b05f8f34572a4c02b44979b9a7d2024-03-12T09:21:48ZengWileyThoracic Cancer1759-77061759-77142023-04-0114111029103510.1111/1759-7714.14842Safety evaluation of immune checkpoint inhibitors combined with chemotherapy for the treatment of small cell lung cancer: A meta‐analysis of randomized controlled trialsVito Longo0Alessandro Rizzo1Annamaria Catino2Michele Montrone3Domenico Galetta4Medical Thoracic Oncology Unit IRCCS Istituto Tumori “Giovanni Paolo II” Bari ItalyStruttura Semplice Dipartimentale Di Oncologia Medica per La Presa in Carico Globale Del Paziente Oncologico “Don Tonino Bello”, I.R.C.C.S. Istituto Tumori “Giovanni Paolo II” Bari ItalyMedical Thoracic Oncology Unit IRCCS Istituto Tumori “Giovanni Paolo II” Bari ItalyMedical Thoracic Oncology Unit IRCCS Istituto Tumori “Giovanni Paolo II” Bari ItalyMedical Thoracic Oncology Unit IRCCS Istituto Tumori “Giovanni Paolo II” Bari ItalyAbstract Background The addition of immune checkpoint inhibitors (ICIs) to chemotherapy is the new standard of care in the first‐line treatment of small cell lung cancer (SCLC). However, although the concomitant use of immunotherapy and chemotherapy can increase the antitumor efficacy, it can also increase toxicity. The present study evaluated the tolerability of immune‐based combinations in the first‐line treatment of SCLC. Methods Relevant trials were identified by searching electronic databases and conference meetings. Seven phase II and III randomized controlled trials and 3766 SCLC patients were included in the meta‐analysis (immune‐based combinations = 2133; chemotherapy = 1633). Outcomes of interest included treatment‐related adverse events (TRAEs) and the rate of discontinuation due to TRAEs. Results Immune‐based combination treatment was associated with a higher risk of grade 3–5 TRAEs (odds ratio [OR], 1.16; 95% confidence interval [CI]: 1.01–1.35). Immune‐based combinations were associated with a higher risk of TRAEs leading to discontinuation (OR, 2.30; 95% CI: 1.17–4.54). No differences were observed in grade 5 TRAEs (OR, 1.56; 95% CI: 0.93–2.63). Conclusion This meta‐analysis indicates that the addition of immunotherapy to chemotherapy in SCLC patients is associated with a higher risk of toxicity and probably of treatment discontinuation. Tools for identifying SCLC patients that would not benefit from immune‐based therapy are urgently needed.https://doi.org/10.1111/1759-7714.14842immune checkpoint inhibitorsimmunotherapymeta‐analysissafetySCLC |
| spellingShingle | Vito Longo Alessandro Rizzo Annamaria Catino Michele Montrone Domenico Galetta Safety evaluation of immune checkpoint inhibitors combined with chemotherapy for the treatment of small cell lung cancer: A meta‐analysis of randomized controlled trials Thoracic Cancer immune checkpoint inhibitors immunotherapy meta‐analysis safety SCLC |
| title | Safety evaluation of immune checkpoint inhibitors combined with chemotherapy for the treatment of small cell lung cancer: A meta‐analysis of randomized controlled trials |
| title_full | Safety evaluation of immune checkpoint inhibitors combined with chemotherapy for the treatment of small cell lung cancer: A meta‐analysis of randomized controlled trials |
| title_fullStr | Safety evaluation of immune checkpoint inhibitors combined with chemotherapy for the treatment of small cell lung cancer: A meta‐analysis of randomized controlled trials |
| title_full_unstemmed | Safety evaluation of immune checkpoint inhibitors combined with chemotherapy for the treatment of small cell lung cancer: A meta‐analysis of randomized controlled trials |
| title_short | Safety evaluation of immune checkpoint inhibitors combined with chemotherapy for the treatment of small cell lung cancer: A meta‐analysis of randomized controlled trials |
| title_sort | safety evaluation of immune checkpoint inhibitors combined with chemotherapy for the treatment of small cell lung cancer a meta analysis of randomized controlled trials |
| topic | immune checkpoint inhibitors immunotherapy meta‐analysis safety SCLC |
| url | https://doi.org/10.1111/1759-7714.14842 |
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