Oncology Unit, ASST Bergamo Ovest, Treviglio (BG).
Oncology Unit, ASST Cremona, Cremona.
J Immunother. 2020 Jan;43(1):1-7. doi: 10.1097/CJI.0000000000000300.
Immune-related adverse events (irAEs) are autoimmune-toxic effects associated with immune checkpoint inhibitors (ICIs) used for the treatment of advanced solid tumors. We performed a systematic review and meta-analysis of the published literature to assess the outcome for cancer patients treated with ICIs who develop irAEs. Two independent reviewers selected prospective or retrospective studies from PubMed, EMBASE, and the Cochrane Library database from their inception to November 2018. Data were pooled using hazard ratios (HRs) for overall survival or progression-free survival or odds ratio for overall response rate of irAEs versus no irAEs according to fixed or random-effect model. HRs for OS (the primary outcome measure) were pooled to provide an aggregate value. A total of 30 studies that included a total of 4324 patients treated with ICIs were selected. Patients who developed irAEs presented a reduced risk of death [HR=0.49, 95% confidence interval (CI): 0.38-0.62; P<0.001]. Similarly, the occurrence of irAEs was associated with a reduced risk of progression (HR=0.51, 95% CI: 0.42-0.64; P<0.001). The odds of response was 4.56 (95% CI: 3.72-5.59; P<0.001). In patients treated with ICIs, irAEs predict survival and response. Although this correlation cannot be fully explained, it may be related to the strongest T-cell activation.
免疫相关不良事件（irAEs）是与免疫检查点抑制剂（ICIs）相关的自身免疫毒性效应，这些抑制剂用于治疗晚期实体瘤。我们对已发表的文献进行了系统评价和荟萃分析，以评估发生 irAEs 的癌症患者接受 ICI 治疗的结果。两位独立的审查员从 PubMed、EMBASE 和 Cochrane Library 数据库中选择了从成立到 2018 年 11 月的前瞻性或回顾性研究。根据固定或随机效应模型，使用总生存率或无进展生存率的风险比（HRs）或总体反应率的优势比来汇总数据。HRs 用于 OS（主要终点测量）以提供综合值。共选择了 30 项研究，共纳入 4324 例接受 ICI 治疗的患者。发生 irAEs 的患者死亡风险降低[HR=0.49，95%置信区间（CI）：0.38-0.62；P<0.001]。同样，irAEs 的发生与进展风险降低相关（HR=0.51，95% CI：0.42-0.64；P<0.001）。反应的可能性为 4.56（95% CI：3.72-5.59；P<0.001）。在接受 ICI 治疗的患者中，irAEs 预测生存和反应。尽管这种相关性不能完全解释，但它可能与最强的 T 细胞激活有关。
