Toxicity profiles of immunochemotherapy for gastric or gastroesophageal junction adenocarcinoma: a systematic review and meta-analysis.

IF 4.9 2区医学 Q2 CELL BIOLOGY

Cellular Oncology Pub Date : 2024-12-01 Epub Date: 2024-12-05 DOI:10.1007/s13402-024-01021-w

Linghong Wan, Fanxuan Tian, Lei Wang, Yongying Hou, Wenkang Liu, Qin Liu, Dongfeng Chen, Xianfeng Li, Junyv Xiang, Zhong-Yi Qin, Tao Wang, Bijng Mao, Linyu Wu, Lu Hu

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引用次数: 0

Abstract

Purpose: Neoadjuvant immunochemotherapy is emerging as a promising regimen for patients with locally advanced gastric and gastroesophageal junction (G/GEJ) adenocarcinoma. However, it remains unclear whether immunochemotherapy will bring more adverse events (AEs) leading to a delay or even cancellation of surgeries. We aimed to provide a comprehensive analysis of the toxicity profiles for immune checkpoint inhibitors (ICIs) combined with chemotherapy among patients with G/GEJ adenocarcinoma.

Methods: Published trials up to January 2024 were identified on Web of Science, Cochrane Library, Embase, and PubMed. Single-group and controlled clinical trials with ICIs in combination with chemotherapy in patients with G/GEJ adenocarcinoma were included. Two reviewers independently extracted data including incidence rate of AEs. The primary outcomes included the proportion of patients with adverse events leading to treatment discontinuation, grade 3 or higher adverse events, and serious adverse events. This study is registered with PROSPERO (CRD42023492676).

Results: Twenty studies were included for a total of 6692 patients. In patients receiving immunochemotherapy, 17% (95% confidence interval (CI), 11-23%) had adverse events leading to treatment discontinuation, 23% (95% CI, 19-27%) had serious adverse events, and 64% (95% CI, 58-70%) had grade 3 or higher adverse events. Compared with patients receiving chemotherapy alone, patients with immunochemotherapy were associated with higher rates of adverse events leading to discontinuation (RR, 1.45; 95% CI, 1.32-1.60), serious adverse events (RR, 1.27; 95% CI, 1.04-1.57), and grade 3 or higher adverse events (RR, 1.15; 95% CI, 1.07-1.23).

Conclusions: In conclusion, the incidence of adverse events leading to discontinuation, serious adverse events, and grade 3 or higher adverse events were higher in patients receiving immunochemotherapy compared to those with chemotherapy.

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免疫化疗治疗胃或胃食管交界处腺癌的毒性概况：一项系统综述和荟萃分析。

目的：新辅助免疫化疗正在成为局部晚期胃和胃食管交界处（G/GEJ）腺癌患者的一种有希望的治疗方案。然而，目前尚不清楚免疫化疗是否会带来更多的不良事件（ae），导致手术延迟甚至取消。我们旨在全面分析免疫检查点抑制剂（ICIs）联合化疗对G/GEJ腺癌患者的毒性。方法：在Web of Science、Cochrane Library、Embase和PubMed上检索截至2024年1月已发表的试验。包括单组和对照临床试验，ICIs联合化疗治疗G/GEJ腺癌患者。两位审稿人独立提取了包括不良事件发生率在内的数据。主要结局包括不良事件导致停药、3级或以上不良事件和严重不良事件的患者比例。本研究已在普洛斯彼罗注册（CRD42023492676）。结果：纳入20项研究，共6692例患者。在接受免疫化疗的患者中，17%（95%置信区间（CI）， 11-23%）发生不良事件导致停药，23% （95% CI, 19-27%）发生严重不良事件，64% （95% CI, 58-70%）发生3级或以上不良事件。与单独接受化疗的患者相比，免疫化疗患者导致停药的不良事件发生率更高(RR, 1.45；95% CI, 1.32-1.60)，严重不良事件(RR, 1.27；95% CI, 1.04-1.57)和3级及以上不良事件(RR, 1.15；95% ci, 1.07-1.23)。结论：综上所述，与化疗患者相比，接受免疫化疗患者导致停药、严重不良事件和3级及以上不良事件的发生率更高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cellular Oncology ONCOLOGY-CELL BIOLOGY

CiteScore

10.30

自引率

1.50%

发文量

审稿时长

12 months

期刊介绍： The Official Journal of the International Society for Cellular Oncology Focuses on translational research Addresses the conversion of cell biology to clinical applications Cellular Oncology publishes scientific contributions from various biomedical and clinical disciplines involved in basic and translational cancer research on the cell and tissue level, technical and bioinformatics developments in this area, and clinical applications. This includes a variety of fields like genome technology, micro-arrays and other high-throughput techniques, genomic instability, SNP, DNA methylation, signaling pathways, DNA organization, (sub)microscopic imaging, proteomics, bioinformatics, functional effects of genomics, drug design and development, molecular diagnostics and targeted cancer therapies, genotype-phenotype interactions. A major goal is to translate the latest developments in these fields from the research laboratory into routine patient management. To this end Cellular Oncology forms a platform of scientific information exchange between molecular biologists and geneticists, technical developers, pathologists, (medical) oncologists and other clinicians involved in the management of cancer patients. In vitro studies are preferentially supported by validations in tumor tissue with clinicopathological associations.