Schaefer Anne, Sachpekidis Christos, Diella Francesca, Doerks Anja, Kratz Anne-Sophie, Meisel Christian, Jackson David B, Soldatos Theodoros G
Molecular Health GmbH, 69115 Heidelberg, Germany.
Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.
Cancers (Basel). 2020 Apr 19;12(4):1008. doi: 10.3390/cancers12041008.
Immune checkpoint inhibition represents an important therapeutic option for advanced melanoma patients. Results from clinical studies have shown that treatment with the inhibitors Pembrolizumab and Nivolumab provides improved response and survival rates. Moreover, combining Nivolumab with the inhibitor Ipilimumab is superior to the respective monotherapies. However, use of these immunotherapies frequently associated with, sometimes life-threatening, immune-related adverse events. Thus, more evidence-based studies are required to characterize the underlying mechanisms, towards more effective clinical management and treatment monitoring. Our study examines two sets of public adverse event data coming from FAERS and VigiBase, each with more than two thousand melanoma patients treated with Pembrolizumab. Standard disproportionality metrics are utilized to characterize the safety of Pembrolizumab and its reaction profile is compared to those of the widely used Ipilimumab and Nivolumab based on melanoma cases that report only one of them. Our results confirm known toxicological considerations for their related and distinct side-effect profiles and highlight specific immune-related adverse reactions. Our retrospective computational analysis includes more patients than examined in other studies and relies on evidence coming from public pharmacovigilance data that contain safety reports from clinical and controlled studies as well as reports of suspected adverse events coming from real-world post-marketing setting. Despite these informative insights, more prospective studies are necessary to fully characterize the efficacy of these agents.
免疫检查点抑制是晚期黑色素瘤患者的一种重要治疗选择。临床研究结果表明,使用派姆单抗和纳武单抗抑制剂进行治疗可提高缓解率和生存率。此外,将纳武单抗与伊匹单抗抑制剂联合使用优于各自的单一疗法。然而,使用这些免疫疗法常常会出现有时甚至危及生命的免疫相关不良事件。因此,需要更多基于证据的研究来阐明其潜在机制,以实现更有效的临床管理和治疗监测。我们的研究检查了来自FAERS和VigiBase的两组公共不良事件数据,每组数据都包含两千多名接受派姆单抗治疗的黑色素瘤患者。使用标准的不成比例度量来描述派姆单抗的安全性,并将其反应特征与基于仅报告其中一种药物的黑色素瘤病例的广泛使用的伊匹单抗和纳武单抗的反应特征进行比较。我们的结果证实了已知的关于它们相关和不同副作用特征的毒理学考量,并突出了特定的免疫相关不良反应。我们的回顾性计算分析纳入的患者比其他研究更多,并且依赖于来自公共药物警戒数据的证据,这些数据包含临床和对照研究的安全报告以及来自真实世界上市后环境的疑似不良事件报告。尽管有这些有益的见解,但仍需要更多前瞻性研究来全面描述这些药物的疗效。