Beijing University of Chinese Medicine, Beijing, People's Republic of China.
Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing, People's Republic of China.
Int Immunopharmacol. 2023 Oct;123:110785. doi: 10.1016/j.intimp.2023.110785. Epub 2023 Aug 21.
Immune checkpoint inhibitors (ICIs) with angiogenesis inhibitors have been used to treat advanced lung cancer. Their associated treatment-related adverse events (trAEs) are currently considered acceptable; however, no conclusion has been reached. We aimed to summarize the trAEs caused by ICIs combined with angiogenesis inhibitors in patients with advanced lung cancer.
Pulled studies met the following criteria: patients with advanced lung cancer who received treatment involving ICIs combined with angiogenesis inhibitors (with or without chemotherapy) in interventional or observational studies. Results included the type and number of trAEs or immune-related adverse events (irAEs), treatment-associated discontinuation and mortality, overall survival (OS), and progression-free survival (PFS).
CRD42022337656.
The study enrolled 32 trials involving 2313 patients who had 7768 any-grade trAEs and 1078 grade ≥3 trAEs. The pooled incidences were 87.33% (95% confidence interval [CI]: 79.49-93.65; I = 94.04%) for any-grade trAEs, and 38.63% (95% CI: 28.28-49.50; I = 95.61%) for grade ≥3 trAEs. There were 132 kinds of any-grade trAEs involving 18 systems, and 99 kinds of grade ≥3 trAEs involving 16 systems. For all trAEs, we observed significant differences in the line of therapy, trial design, therapy combination, and types of angiogenesis inhibitors (all P < 0.05). The rate of trAEs increased with dosage and frequency of medication. Pooled incidences of discontinuation and mortality were 10.64% and 0.81%, respectively. Nearly 647 patients experienced irAEs, including 636 any-grade irAEs and 154 grade ≥3 irAEs.
Overall, the incidence of trAEs caused by ICIs combined with angiogenesis inhibitors is generally acceptable. These trAEs have a wide spectrum nearly covering the full range of adverse events. Grade ≥3 trAEs are more closely associated with angiogenesis inhibitors than any grade. However, treatment-associated mortality remains concerning.
免疫检查点抑制剂（ICIs）联合血管生成抑制剂已被用于治疗晚期肺癌。其相关的治疗相关不良反应（trAEs）目前被认为是可接受的；然而，目前尚无定论。我们旨在总结 ICIs 联合血管生成抑制剂治疗晚期肺癌患者的 trAEs。
纳入符合以下标准的研究：在干预性或观察性研究中，接受 ICIs 联合血管生成抑制剂（联合或不联合化疗）治疗的晚期肺癌患者。结果包括 trAEs 或免疫相关不良反应（irAEs）的类型和数量、与治疗相关的停药和死亡率、总生存期（OS）和无进展生存期（PFS）。
CRD42022337656。
该研究纳入了 32 项试验，共纳入 2313 名患者，共发生 7768 例任何级别 trAEs 和 1078 例 3 级及以上 trAEs。任何级别 trAEs 的总发生率为 87.33%（95%可信区间：79.49-93.65；I=94.04%），3 级及以上 trAEs 的总发生率为 38.63%（95%可信区间：28.28-49.50；I=95.61%）。任何级别 trAEs 涉及 18 个系统，132 种；3 级及以上 trAEs 涉及 16 个系统，99 种。对于所有 trAEs，我们观察到治疗线、试验设计、治疗联合以及血管生成抑制剂类型之间存在显著差异（均 P<0.05）。trAEs 的发生率随药物剂量和频率的增加而增加。停药和死亡率的发生率分别为 10.64%和 0.81%。近 647 名患者发生 irAEs，包括 636 例任何级别 irAEs 和 154 例 3 级及以上 irAEs。
总体而言，ICIs 联合血管生成抑制剂引起的 trAEs 发生率通常是可以接受的。这些 trAEs 谱广泛，几乎涵盖了所有不良反应。3 级及以上 trAEs 与血管生成抑制剂的相关性比任何级别都更密切。然而，与治疗相关的死亡率仍然令人担忧。
