The Risk of Immune-Related Thyroid Dysfunction Induced by PD-1/PD-L1 Inhibitors in Cancer Patients: An Updated Systematic Review and Meta-Analysis
BackgroundThyroid dysfunction is common for cancer patients receiving PD-1/PD-L1 inhibitor therapies. To clarify the incidence risk of thyroid dysfunction would be important for guiding anti-PD-1 and anti-PD-L1 immunotherapy. Therefore, the updated meta-analysis was conducted to evaluate the inciden...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-07-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2021.667650/full |
| _version_ | 1819092402773688320 |
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| author | Yuan Tian Yuan Tian Ran Li Yan Liu Meng Li Yuxiao Song Yan Zheng Yan Zheng Aiqin Gao Qing Wen Guohai Su Yuping Sun Yuping Sun |
| author_facet | Yuan Tian Yuan Tian Ran Li Yan Liu Meng Li Yuxiao Song Yan Zheng Yan Zheng Aiqin Gao Qing Wen Guohai Su Yuping Sun Yuping Sun |
| author_sort | Yuan Tian |
| collection | DOAJ |
| description | BackgroundThyroid dysfunction is common for cancer patients receiving PD-1/PD-L1 inhibitor therapies. To clarify the incidence risk of thyroid dysfunction would be important for guiding anti-PD-1 and anti-PD-L1 immunotherapy. Therefore, the updated meta-analysis was conducted to evaluate the incidence risk of thyroid dysfunction caused by PD-1/PD-L1 inhibitors.MethodsPD-1/PD-L1 inhibitor related clinical trials were collected by a systematic search of the PubMed. Some relevant studies were identified by a manual search. The incidence risk of all grades and grades 3-5 was analyzed and evaluated by random effect model. The Newcastle Ottawa Scale was used for the quality assessment of all clinical trials.ResultsForty-three clinical trials were collected. Compared with chemotherapy, the risk of hypothyroidism of all grades was significantly higher (OR=7.15, 95%CI:[4.85, 10.55], I2 = 40%, Z=9.91(P <0.00001)) in PD-1/PD-L1 group. Similar results could also be noted, when the control group was placebo or CTLA-4. When PD-1/PD-L1 was combined with other treatments for cancer patients, the risk of hypothyroidism of all grades was also significantly increased. Similar to the analysis results of hypothyroidism, PD-1/PD-L1 inhibitors played the same role in increasing the risk of hyperthyroidism and thyroiditis. Few significant analysis results was noted, when the risk of thyroid dysfunction of grades 3-5 was assessed.ConclusionWhether used alone or in combination with other anti-tumor drugs, PD-1/PD-L1 inhibitors increased the risk of thyroid dysfunction, especially for hypothyroidism. Furthermore, PD-1/PD-L1 was better than chemotherapy and CTLA-4 in increasing the risk of thyroid dysfunction. |
| first_indexed | 2024-12-21T22:55:03Z |
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| id | doaj.art-d15d5db4673842d28c94a1256c181c1f |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-21T22:55:03Z |
| publishDate | 2021-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-d15d5db4673842d28c94a1256c181c1f2022-12-21T18:47:28ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-07-011110.3389/fonc.2021.667650667650The Risk of Immune-Related Thyroid Dysfunction Induced by PD-1/PD-L1 Inhibitors in Cancer Patients: An Updated Systematic Review and Meta-AnalysisYuan Tian0Yuan Tian1Ran Li2Yan Liu3Meng Li4Yuxiao Song5Yan Zheng6Yan Zheng7Aiqin Gao8Qing Wen9Guohai Su10Yuping Sun11Yuping Sun12Department of Oncology, Jinan Central Hospital Affiliated to Shandong University, Jinan, ChinaSpecial Care Department of Proton Therapy Center, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, ChinaDepartment of Oncology, Jinan Central Hospital, Weifang Medical University, Weifang, ChinaQilu Hospital of Shandong University, Jinan, ChinaHuman Resources Department, Jinan Central Hospital Affiliated to Shandong University, Jinan, ChinaJinan Center for Disease Control and Prevention, Jinan, ChinaResearch Center of Translational Medicine, Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, ChinaResearch Center of Translational Medicine, Jinan Central Hospital, Cheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Oncology, Jinan Central Hospital Affiliated to Shandong University, Jinan, ChinaJinan Clinical Research Center of Shandong First Medical University, Jinan, China0Department of Cardiovascular Diseases, Jinan Central Hospital Affiliated to Shandong University, Jinan, ChinaDepartment of Oncology, Jinan Central Hospital Affiliated to Shandong University, Jinan, China1Department of Oncology, Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, ChinaBackgroundThyroid dysfunction is common for cancer patients receiving PD-1/PD-L1 inhibitor therapies. To clarify the incidence risk of thyroid dysfunction would be important for guiding anti-PD-1 and anti-PD-L1 immunotherapy. Therefore, the updated meta-analysis was conducted to evaluate the incidence risk of thyroid dysfunction caused by PD-1/PD-L1 inhibitors.MethodsPD-1/PD-L1 inhibitor related clinical trials were collected by a systematic search of the PubMed. Some relevant studies were identified by a manual search. The incidence risk of all grades and grades 3-5 was analyzed and evaluated by random effect model. The Newcastle Ottawa Scale was used for the quality assessment of all clinical trials.ResultsForty-three clinical trials were collected. Compared with chemotherapy, the risk of hypothyroidism of all grades was significantly higher (OR=7.15, 95%CI:[4.85, 10.55], I2 = 40%, Z=9.91(P <0.00001)) in PD-1/PD-L1 group. Similar results could also be noted, when the control group was placebo or CTLA-4. When PD-1/PD-L1 was combined with other treatments for cancer patients, the risk of hypothyroidism of all grades was also significantly increased. Similar to the analysis results of hypothyroidism, PD-1/PD-L1 inhibitors played the same role in increasing the risk of hyperthyroidism and thyroiditis. Few significant analysis results was noted, when the risk of thyroid dysfunction of grades 3-5 was assessed.ConclusionWhether used alone or in combination with other anti-tumor drugs, PD-1/PD-L1 inhibitors increased the risk of thyroid dysfunction, especially for hypothyroidism. Furthermore, PD-1/PD-L1 was better than chemotherapy and CTLA-4 in increasing the risk of thyroid dysfunction.https://www.frontiersin.org/articles/10.3389/fonc.2021.667650/fullthyroid dysfunctionPD-1/PD-L1 inhibitorscancermeta-analysisrisk |
| spellingShingle | Yuan Tian Yuan Tian Ran Li Yan Liu Meng Li Yuxiao Song Yan Zheng Yan Zheng Aiqin Gao Qing Wen Guohai Su Yuping Sun Yuping Sun The Risk of Immune-Related Thyroid Dysfunction Induced by PD-1/PD-L1 Inhibitors in Cancer Patients: An Updated Systematic Review and Meta-Analysis Frontiers in Oncology thyroid dysfunction PD-1/PD-L1 inhibitors cancer meta-analysis risk |
| title | The Risk of Immune-Related Thyroid Dysfunction Induced by PD-1/PD-L1 Inhibitors in Cancer Patients: An Updated Systematic Review and Meta-Analysis |
| title_full | The Risk of Immune-Related Thyroid Dysfunction Induced by PD-1/PD-L1 Inhibitors in Cancer Patients: An Updated Systematic Review and Meta-Analysis |
| title_fullStr | The Risk of Immune-Related Thyroid Dysfunction Induced by PD-1/PD-L1 Inhibitors in Cancer Patients: An Updated Systematic Review and Meta-Analysis |
| title_full_unstemmed | The Risk of Immune-Related Thyroid Dysfunction Induced by PD-1/PD-L1 Inhibitors in Cancer Patients: An Updated Systematic Review and Meta-Analysis |
| title_short | The Risk of Immune-Related Thyroid Dysfunction Induced by PD-1/PD-L1 Inhibitors in Cancer Patients: An Updated Systematic Review and Meta-Analysis |
| title_sort | risk of immune related thyroid dysfunction induced by pd 1 pd l1 inhibitors in cancer patients an updated systematic review and meta analysis |
| topic | thyroid dysfunction PD-1/PD-L1 inhibitors cancer meta-analysis risk |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2021.667650/full |
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