A large scale meta analysis identifies common adverse events with checkpoint inhibitors vs chemotherapy in melanoma patients

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via ScienceDirect Publication: International Immunopharmacology

Publication date: September 2019
Source: International Immunopharmacology, Volume 74
Author(s): Ruyi Zhang, Xuehui Li, Zhiyu You, Li Jiang, Yaguang Weng, Qiong Shi, Lin Du, Shujuan Yan

Abstract

Background

A meta-analysis was performed to assess the risk of common adverse events in melanoma patients treated with checkpoint inhibitors.

Methods

Eligible studies were downloaded from PubMed, Embase, and Cochrane databases based on an established strategy. Review manager version 5.3 was used to analyze data.

Results

After exclusion of ineligible studies, six studies were finally included in the meta-analysis, which comprised of 2136 patients in intervention group and 1773 patients in control group. There was a difference in low grade risk of pruritus (OR 5.63, 95% CI 2.92–10.85, P < 0.00001), diarrhea/colitis (OR 1.51, 95% CI 1.09–2.09, P = 0.01), but not fatigue (low grade, OR 0.96, 95% CI 0.72–1.29, P = 0.80; high grade, OR 0.72, 95% CI 0.23–2.24, P = 0.57) and some high grade risk between the intervention group and control group. Subgroups analysis revealed that low grade risk of pruritus (OR 8.17, 95% CI 4.29–15.55, P < 0.00001) and high grade risk of pruritus (OR 7.08, 95% CI 1.25–40.09, P = 0.03) were significantly different between patients treated with chemotherapy and those treated with checkpoint inhibitors. But fatigue and diarrhea/colitis were not different between the two groups.

Conclusion

Checkpoint inhibitors are associated with a higher risk in some side effects than chemotherapy in melanoma patients. Therefore, strategies that reduce the risk of adverse events in patients taking checkpoint inhibitors should be developed.