Safety and efficacy of restarting immune checkpoint inhibitors in non-small cell lung cancer patients following immune-related adverse events: a systematic review and meta-analysis.

IF 2.8 3区 医学 Q2 ONCOLOGY
Clinical & Translational Oncology Pub Date : 2025-01-01 Epub Date: 2024-06-26 DOI:10.1007/s12094-024-03529-x
Kexin Tan, Aolin Wang, Yumin Zheng, Shuo Wang, Chao Wang, Jia Li, Xingyu Lu, Huijing Dong, Jiabin Zheng, Huijuan Cui
{"title":"Safety and efficacy of restarting immune checkpoint inhibitors in non-small cell lung cancer patients following immune-related adverse events: a systematic review and meta-analysis.","authors":"Kexin Tan, Aolin Wang, Yumin Zheng, Shuo Wang, Chao Wang, Jia Li, Xingyu Lu, Huijing Dong, Jiabin Zheng, Huijuan Cui","doi":"10.1007/s12094-024-03529-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This meta-analysis aims to evaluate the safety and efficacy of restarting immune checkpoint inhibitors (ICIs) in patients with non-small cell lung cancer (NSCLC) after experiencing immune-related adverse events (irAEs).</p><p><strong>Methods: </strong>A comprehensive search of PubMed, Web of Science, Embase, and the Cochrane Library was conducted to identify studies investigating the safety and efficacy of restarting ICIs in NSCLC patients after irAEs. Outcome measures, including objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) after ICI restarting, were extracted. Meta-analysis was performed using the R meta-package.</p><p><strong>Results: </strong>Four studies involving a total of 326 subjects were included, comprising 137 patients who restarted ICI treatment after irAEs and 189 patients who did not restart ICI treatment. The results revealed that ICI restarting was associated with an increased ORR (OR = 2.36, 95% CI 1.49-3.84), prolonged PFS (HR = 0.60, 95% CI 0.42-0.86), and prolonged OS (HR = 0.65, 95% CI 0.43-0.99) compared to non-restarting. The incidence of irAEs after ICI restarting was 45% (95% CI 0.27-0.63).</p><p><strong>Conclusion: </strong>Restarting ICI treatment after discontinuation due to previous irAEs appears to be a reasonable option for NSCLC patients. However, a comprehensive assessment of the potential benefits and risks to individual patients is crucial, and close monitoring of irAEs is warranted.</p>","PeriodicalId":50685,"journal":{"name":"Clinical & Translational Oncology","volume":" ","pages":"196-203"},"PeriodicalIF":2.8000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical & Translational Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12094-024-03529-x","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/26 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: This meta-analysis aims to evaluate the safety and efficacy of restarting immune checkpoint inhibitors (ICIs) in patients with non-small cell lung cancer (NSCLC) after experiencing immune-related adverse events (irAEs).

Methods: A comprehensive search of PubMed, Web of Science, Embase, and the Cochrane Library was conducted to identify studies investigating the safety and efficacy of restarting ICIs in NSCLC patients after irAEs. Outcome measures, including objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) after ICI restarting, were extracted. Meta-analysis was performed using the R meta-package.

Results: Four studies involving a total of 326 subjects were included, comprising 137 patients who restarted ICI treatment after irAEs and 189 patients who did not restart ICI treatment. The results revealed that ICI restarting was associated with an increased ORR (OR = 2.36, 95% CI 1.49-3.84), prolonged PFS (HR = 0.60, 95% CI 0.42-0.86), and prolonged OS (HR = 0.65, 95% CI 0.43-0.99) compared to non-restarting. The incidence of irAEs after ICI restarting was 45% (95% CI 0.27-0.63).

Conclusion: Restarting ICI treatment after discontinuation due to previous irAEs appears to be a reasonable option for NSCLC patients. However, a comprehensive assessment of the potential benefits and risks to individual patients is crucial, and close monitoring of irAEs is warranted.

Abstract Image

非小细胞肺癌患者发生免疫相关不良事件后重启免疫检查点抑制剂的安全性和有效性:系统综述和荟萃分析。
研究目的这项荟萃分析旨在评估非小细胞肺癌(NSCLC)患者在出现免疫相关不良事件(irAEs)后重新开始使用免疫检查点抑制剂(ICIs)的安全性和有效性:方法:对PubMed、Web of Science、Embase和Cochrane图书馆进行了全面检索,以确定调查NSCLC患者在发生irAEs后重启ICIs的安全性和有效性的研究。研究提取了结果指标,包括重启 ICI 后的客观反应率 (ORR)、无进展生存期 (PFS) 和总生存期 (OS)。使用R元软件包进行了元分析:结果:共纳入四项研究,涉及 326 例受试者,其中 137 例患者在发生虹膜AE 后重新开始 ICI 治疗,189 例患者未重新开始 ICI 治疗。结果显示,与未重启ICI治疗相比,重启ICI治疗与ORR增加(OR = 2.36,95% CI 1.49-3.84)、PFS延长(HR = 0.60,95% CI 0.42-0.86)和OS延长(HR = 0.65,95% CI 0.43-0.99)相关。ICI重启后irAEs的发生率为45%(95% CI 0.27-0.63):结论:对于NSCLC患者来说,因既往虹膜不良反应而中断ICI治疗后重新开始ICI治疗似乎是一个合理的选择。结论:对于 NSCLC 患者来说,因既往虹膜不良反应而中断 ICI 治疗后重新开始 ICI 治疗似乎是一种合理的选择。然而,全面评估每位患者的潜在获益和风险至关重要,并且需要密切监测虹膜不良反应。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
6.20
自引率
2.90%
发文量
240
审稿时长
1 months
期刊介绍: Clinical and Translational Oncology is an international journal devoted to fostering interaction between experimental and clinical oncology. It covers all aspects of research on cancer, from the more basic discoveries dealing with both cell and molecular biology of tumour cells, to the most advanced clinical assays of conventional and new drugs. In addition, the journal has a strong commitment to facilitating the transfer of knowledge from the basic laboratory to the clinical practice, with the publication of educational series devoted to closing the gap between molecular and clinical oncologists. Molecular biology of tumours, identification of new targets for cancer therapy, and new technologies for research and treatment of cancer are the major themes covered by the educational series. Full research articles on a broad spectrum of subjects, including the molecular and cellular bases of disease, aetiology, pathophysiology, pathology, epidemiology, clinical features, and the diagnosis, prognosis and treatment of cancer, will be considered for publication.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信