Risk of endocrine adverse events in cancer patients treated with PD-1 inhibitors: a systematic review and meta-analysis

Immunotherapy ◽  
2017 ◽  
Vol 9 (3) ◽  
pp. 261-272 ◽  
Author(s):  
Yan hong Shang ◽  
Yu Zhang ◽  
Jing hua Li ◽  
Peng Li ◽  
Xi Zhang
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Cancer Patients ◽  
Meta Analysis

Antifungal Prophylaxis in Cancer Patients After Chemotherapy or Hematopoietic Stem-Cell Transplantation: Systematic Review and Meta-Analysis

2007 ◽  
Vol 25 (34) ◽  
pp. 5471-5489 ◽  
Author(s):  
Eyal Robenshtok ◽  
Anat Gafter-Gvili ◽  
Elad Goldberg ◽  
Miriam Weinberger ◽  
Moshe Yeshurun ◽  
...  
Keyword(s):  
Systematic Review ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Adverse Events ◽  
Cancer Patients ◽  
Meta Analysis ◽  
Antifungal Prophylaxis ◽  
Hematopoietic Stem ◽  
All Cause Mortality ◽  
Related Mortality

Purpose To evaluate the effect of antifungal prophylaxis on all-cause mortality as primary outcome, invasive fungal infections (IFIs), and adverse events. Many studies have evaluated the role of antifungal prophylaxis in cancer patients, with inconsistent conclusions. Methods We performed a systematic review and meta-analysis of randomized, controlled trials comparing systemic antifungals with placebo, no intervention, or other antifungal agents for prophylaxis in cancer patients after chemotherapy. The Cochrane Library, MEDLINE, conference proceedings, and references were searched. Two reviewers independently appraised the quality of trials and extracted data. Results Sixty-four trials met inclusion criteria. Antifungal prophylaxis decreased all-cause mortality significantly at end of follow-up compared with placebo, no treatment, or nonsystemic antifungals (relative risk [RR], 0.84; 95% CI, 0.74 to 0.95). In allogeneic hematopoietic stem-cell transplantation (HSCT) recipients, prophylaxis reduced all-cause mortality (RR, 0.62; 95% CI, 0.45 to 0.85), fungal-related mortality, and documented IFI. In acute leukemia patients, there was a significant reduction in fungal-related mortality and documented IFI, whereas the difference in mortality was only borderline significant (RR, 0.88; 95% CI, 0.74 to 1.06). Prophylaxis with itraconazole suspension reduced documented IFI when compared with fluconazole, with no difference in survival, and at the cost of more adverse events. On the basis of two studies, posaconazole prophylaxis reduced all-cause mortality (RR, 0.74; 95% CI, 0.56 to 0.98), fungal-related mortality, and IFI when compared with fluconazole. Conclusion Antifungal prophylaxis decreases all-cause mortality significantly in patients after chemotherapy. Antifungal prophylaxis should be administered to patients undergoing allogeneic HSCT, and should probably be administered to high-risk acute leukemia patients.

scholarly journals P01.06 Overweight and obesity as biomarkers for survival outcomes and immune related adverse events undergoing immunotherapy – a systematic review and meta-analysis

2021 ◽  
Vol 9 (Suppl 1) ◽  
pp. A5.2-A6
Author(s):  
P Trinkner ◽  
S Günther ◽  
M von Bergwelt ◽  
D Cordas dos Santos ◽  
S Theurich
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Cancer Patients ◽  
Meta Analysis ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Obese Patients ◽  
Increased Risk ◽  
Underweight Patients ◽  
The Impact

BackgroundThe impact of overweight/obesity in cancer patients treated with immune checkpoint inhibitors (ICIs) is controversial. To further contribute to this debate, we performed a systematic review and meta-analysis of published articles evaluating the effects of overweight/obesity on survival and immune-related adverse events (irAEs).Materials and MethodsIn analogy to Cochrane recommendations, systematic literature searches included all published articles in PubMed until February 2021 with key terms ‘obesity’ and ‘overweight’ and ICI treatment irrespective of cancer entity and ICI used. Further selection criteria for meta-analysis included WHO cut-offs for overweight/obesity. For the random effects meta-analysis, we used Hazard Ratios (HR) for overall and progression-free survival (OS, PFS) and Odds Ratios (OR) for occurrence of irAEs with corresponding 95% confidence intervals (95%CI), respectively.ResultsA total of 30 studies (12,895 patients, 38% female) selected for meta-analysis revealed a superior survival of overweight/obese patients (PFS: HR 0.9, 95%CI 0.77-1.04, p = 0.11; OS: 0.74, 95%CI 0.63-0.92, p = 0.0005) compared to normal weight patients. In subgroup analyses based on sex, overweight/obese male patients showed increased survival (PFS: HR 0.79, 95%CI 0.63-1.00, p = 0.05; OS: 0.71, 95%CI 0.58-0.86, p = 0.0005), whereas overweight/obese female patients had similar survival probabilities compared to their normal weight counterparts (PFS: HR 1.01, 95%CI 0.69-1.47, p = 0.96; OS: HR 0.73, 95%CI 0.48-1.10, p = 0.13). Underweight patients showed inferior survival (PFS: HR 1.48, 95%CI 1.07-2.04, p = 0.02; OS: HR 1.86, 95%CI 1.13-3.04, p = 0.01). In addition, overweight/obese patients had a higher risk of developing irAEs with grade ≥ 3 (OR 1.91, 95%CI 1.18-3.10, p = 0.008).ConclusionsOur meta-analysis revealed that overweight/obesity is a beneficial factor for PFS and OS in a mixed cohort of cancer patients undergoing ICI treatment accompanied by an increased risk of severe irAEs. The differences between overweight/obese males and overweight/obese females might point to sex specific adipose distribution patterns and interactions of sex steroids on a molecular level. A significant number of studies included underweight patients into normal weight control groups which led to a compromised interpretation of the data and should be addressed in future studies.Disclosure InformationP. Trinkner: None. S. Günther: None. M. von Bergwelt: None. D. Cordas dos Santos: None. S. Theurich: None.

Anti-EGFR monoclonal antibodies and risk of severe Haematological adverse events in Cancer Patients: a systematic review and meta-analysis

2015 ◽  
Vol 37 (8) ◽  
pp. e83
Author(s):  
M. Miroddi ◽  
P. Pellegrino ◽  
C. Sterrantino ◽  
L. Caridi ◽  
A. Rollo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Monoclonal Antibodies ◽  
Adverse Events ◽  
Cancer Patients ◽  
Meta Analysis

scholarly journals P01.08 Sarcopenia as biomarker for immunotherapy outcomes and immune-related adverse events – a systematic review and meta-analysis

2021 ◽  
Vol 9 (Suppl 1) ◽  
pp. A7.1-A7
Author(s):  
S Günther ◽  
P Trinkner ◽  
M von Bergwelt ◽  
D Cordas dos Santos ◽  
S Theurich
Keyword(s):  
Systematic Review ◽  
Skeletal Muscle ◽  
Risk Factor ◽  
Adverse Events ◽  
Cancer Patients ◽  
Meta Analysis ◽  
Lumbar Vertebrae ◽  
Psoas Muscle ◽  
Skeletal Muscle Index ◽  
The Impact

BackgroundSarcopenia is an established risk factor for oncologic treatments like surgical interventions and conventional chemotherapy. However, the impact of sarcopenia on treatment and immune-related adverse events (irAEs) of cancer patients treated with immune checkpoint inhibitors (ICIs) continues to be debated. Therefore, we performed a systematic review and meta-analysis of all published articles evaluating the effects of sarcopenia on survival outcomes and irAEs of patients undergoing ICI treatment.Materials and MethodsIn analogy to the Cochrane guidelines for systematic reviews, we performed a systematic literature search including all published articles in PubMed until February 2021 for the key terms ‘sarcopenia’ or ‘sarcopenic obesity’ in combination with several terms for ICI treatments, irrespective of cancer entity and ICI used. Further selection criteria for meta-analysis included defined cut-offs for sarcopenia. Reported outcomes included progression-free survival (PFS), overall survival (OS) and the frequency of irAEs. For the random effects meta-analysis, we used Hazard Ratios (HR) for OS and PFS and Odds Ratios (OR) for occurrence of irAEs with corresponding 95% confidence intervals (95%CI), respectively.ResultsA total of 15 studies with 1,428 patients were selected to be eligible for meta-analysis. To evaluate muscle mass, all studies used CT-derived body composition parameters at the third lumbar vertebrae level and defined sarcopenia by using skeletal muscle index (SMI), psoas muscle index (PMI) or skeletal muscle density (SMD). Sarcopenic patients showed an inferior survival compared to non-sarcopenic patients with a combined HR for PFS with 1.53 (95%CI 1.23-1.91, p= 0.0001) and for OS with 1.6 (95% CI 1.23-2.09, p= 0,0005). Frequency of irAEs did not differ between sarcopenic and non-sarcopenic patients regardless of irAE grade (irAEs of grade≥3: OR 1.14, 95%CI 0.65-2.01, p = 0.64, irAEs of any grade: OR 0.96, 95%CI 0.65-1.42, p = 0.85).ConclusionsThis is the first meta-analysis that assessed sarcopenia in a mixed cohort of cancer patients. It revealed that sarcopenia is an adverse risk factor for survival of patients undergoing ICI treatment without affecting the risk of developing irAEs. Future studies may address sarcopenia as a patient-derived risk factor emphasizing the importance of nutrition and physical activity interventions.Disclosure InformationS. Günther: None. P. Trinkner: None. M. von Bergwelt: None. D. Cordas dos Santos: None. S. Theurich: None.

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