免疫检查点抑制剂治疗晚期非小细胞肺癌患者的电解质紊乱：系统评价和荟萃分析。
Electrolyte disorders in advanced non-small cell lung cancer patients treated with immune check-point inhibitors: A systematic review and meta-analysis.
机构信息
Clinical Oncology, Polytechnic University of Marche, AOU Ospedali Riuniti, Via Conca 71, 60126, Ancona, Italy.
Clinical Oncology, Polytechnic University of Marche, AOU Ospedali Riuniti, Via Conca 71, 60126, Ancona, Italy.
出版信息
Crit Rev Oncol Hematol. 2020 Jul;151:102974. doi: 10.1016/j.critrevonc.2020.102974. Epub 2020 May 4.
BACKGROUND
Aim of this meta-analysis was to determine the relative risk (RR) of electrolyte disorders (EDs) in advanced non-small cell lung cancer (aNSCLC) patients treated with immune check-point inhibitors (ICIs).
METHODS
We searched for phase II/III randomized controlled trials (RCTs) comparing ICIs (alone or combined with chemotherapy) with standard chemotherapy in aNSCLC. Summary incidence and RR were calculated.
RESULTS
Six RCTs with data on all-grade hyponatremia were identified (n = 3257). The incidence was 8.7 % in the study group and 4.9 % in the control group (RR 1.78, 95 %CI 1.12-2.80). Looking at all-grade hypokalemia, 7 RCTs were included (n = 4119). Incidence was 10.4 % in ICIs-treated patients and 5.9 % in the control arms (RR 1.62, 95 % CI 1.30-2.02).
CONCLUSIONS
Treatment with ICIs in aNSCLC is associated with a significant increased risk of hyponatremia and hypokalemia compared to chemotherapy. Monitoring of electrolyte levels should be emphasized in this setting.
背景
本荟萃分析旨在确定接受免疫检查点抑制剂 (ICI) 治疗的晚期非小细胞肺癌 (aNSCLC) 患者发生电解质紊乱 (ED) 的相对风险 (RR)。
方法
我们检索了比较 ICI（单独或联合化疗）与 aNSCLC 标准化疗的 II/III 期随机对照试验 (RCT)。计算了汇总发生率和 RR。
结果
确定了 6 项具有全级别低钠血症数据的 RCT（n = 3257）。研究组的发生率为 8.7%，对照组为 4.9%（RR 1.78，95%CI 1.12-2.80）。观察全级别低钾血症时，纳入了 7 项 RCT（n = 4119）。ICI 治疗组的发生率为 10.4%，对照组为 5.9%（RR 1.62，95%CI 1.30-2.02）。
结论
与化疗相比，ICI 治疗 aNSCLC 与明显增加的低钠血症和低钾血症风险相关。在这种情况下，应强调监测电解质水平。
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