Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Pivot Concepts:
Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Target Concepts:
Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Query: KEGG:D03301 (
PDL
)
658
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Background:
We performed a systematic review and meta-analysis to evaluate the risk of pneumonitis and pneumonia associated with immune checkpoint inhibitors (ICIs) for solid tumors.
Methods:
The following keywords were used in searching the Embase and PubMed database: pneumonitis, pneumonia, and immune checkpoint inhibitors. The data was analyzed by using the R software and Metafor package.
Results:
Among 3,436 studies, 23 randomized clinical trials (RCTs) met our selection criteria which included data from
12,876
patients. Compared with chemotherapy,
PD-1
inhibitors showed significant increase in grade 1-5 and grade 3-5 pneumonitis (RR, 5.17, 95% CI: 2.82-9.47,
p
< 0.001; RR, 4.14, 95% CI: 1.82-9.42,
p
< 0.001), but not in pneumonia. PD-L1 inhibitors showed significant increase in grade 1-5 pneumonitis and pneumonia (RR, 3.25, 95% CI: 1.61-6.57,
p
< 0.001; RR, 2.11, 95% CI: 1.20-3.70,
p
< 0.001). There was no significant difference in any grade pneumonitis and pneumonia in cytotoxic T lymphocyte-associated protein 4 (CTLA4) inhibitors subgroup.
Programmed cell death protein 1
(
PD-1
) inhibitor (nivolumab and pembrolizumab) both showed significant increase in grade 1-5 pneumonitis, and pembrolizumab specially tended to increase grade 3-5 pneumonitis. (RR, 5.64 95% CI: 1.94-16.38,
p
< 0.001). Compared with
PD-1
inhibitor (nivolumab) or CTLA-4 inhibitor (ipilimumab) monotherapy,
PD-1
inhibitor, and CTLA-4 inhibitor (nivolumab plus ipilimumab) combination therapies showed significant increase in grade 1-5 and grade 3-5 pneumonitis (RR 3.47, 95%CI:1.76-6.83,
p
< 0.001; RR 3.48, 95%CI: 1.10-11.02,
p
< 0.001).
Conclusions:
PD-1
/PD-L1 inhibitors treatment could increase the risk of all-grade pneumonitis. CTLA4 inhibitor ipilimumab treatment alone could not increase the risk of pneumonitis but could augment the risk of pneumonitis in
PD-1
/PD-L1 inhibitor treated patients. There was no significant increase in the risk of pneumonia after either
PD-1
/
PDL
-1inhibitor or CTLA4 inhibitor treatment alone or in combination.
...
PMID:Risk of Pneumonitis and Pneumonia Associated With Immune Checkpoint Inhibitors for Solid Tumors: A Systematic Review and Meta-Analysis. 3077 52