First Clinical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
Department of Gerontology, The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong, China.
Immunotherapy. 2022 May;14(7):577-592. doi: 10.2217/imt-2021-0223. Epub 2022 Apr 4.
The advent of PD-1/L1 inhibitors has changed the landscape for patients with non-small-cell lung cancer (NSCLC). Meanwhile, the adverse events of PD-1/L1 inhibitors have been focused. The Cochrane Central Register of Controlled Trials, PubMed and Embase databases and ClinicalTrials.gov were searched from inception to February 2021. 18 studies involving 11,394 patients with NSCLC were included. PD-1/L1 inhibitor monotherapy was associated (relative risk, 95% confidence interval) with an increased risk of pericardial effusion (2.72 [1.45-5.12]; p = 0.002) and cardiac tamponade (2.76 [1.15-6.62]; p = 0.023), whereas PD-1/L1 inhibitors combined with chemotherapy did not increase the risk of pericardial effusion and cardiac tamponade (3.08 [0.93-10.21]; p = 0.066 and 3.27 [0.37-28.94]; p = 0.288, respectively). For patients with NSCLC, treatment with PD-1/L1 inhibitor monotherapy increases the risk of pericardial effusion and cardiac tamponade, but PD-1/L1 inhibitors combined with chemotherapy do not.
PD-1/L1 抑制剂的出现改变了非小细胞肺癌（NSCLC）患者的治疗格局。与此同时，人们也关注到 PD-1/L1 抑制剂的不良反应。我们从 Cochrane 中央对照试验注册库、PubMed 和 Embase 数据库以及 ClinicalTrials.gov 中检索了从建库到 2021 年 2 月的相关文献，共纳入了 18 项涉及 11394 例 NSCLC 患者的研究。PD-1/L1 抑制剂单药治疗与心包积液（RR，95%CI：2.72[1.45-5.12]；p=0.002）和心脏压塞（RR，95%CI：2.76[1.15-6.62]；p=0.023）风险增加相关，而 PD-1/L1 抑制剂联合化疗并未增加心包积液和心脏压塞的风险（RR，95%CI：3.08[0.93-10.21]；p=0.066 和 RR，95%CI：3.27[0.37-28.94]；p=0.288）。对于 NSCLC 患者，PD-1/L1 抑制剂单药治疗增加了心包积液和心脏压塞的风险，但 PD-1/L1 抑制剂联合化疗不会。
