Cargando…
The incidence of gastrointestinal adverse events in patients with advanced non-small cell lung cancer (NSCLC) treated with PD-1 inhibitors: a meta-analysis
BACKGROUND: We conducted a meta-analysis to evaluates the incidence of the gastrointestinal (GI) adverse events with the use of PD-1 inhibitors among patients with advanced non-small cell lung cancer (NSCLC). METHODS: The PICOs (participants, intervention, comparison, and outcomes) elements were use...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8798015/ https://www.ncbi.nlm.nih.gov/pubmed/35116644 http://dx.doi.org/10.21037/tcr-21-125 |
_version_ | 1784641693186785280 |
---|---|
author | Huo, Geng-Wei Zhu, Fu-Yi Zuo, Ran Song, Ying Chen, Wei-Dong Chen, Wen-Ming Zhang, Hong-Mei Jia, Sha-Sha Chen, Peng |
author_facet | Huo, Geng-Wei Zhu, Fu-Yi Zuo, Ran Song, Ying Chen, Wei-Dong Chen, Wen-Ming Zhang, Hong-Mei Jia, Sha-Sha Chen, Peng |
author_sort | Huo, Geng-Wei |
collection | PubMed |
description | BACKGROUND: We conducted a meta-analysis to evaluates the incidence of the gastrointestinal (GI) adverse events with the use of PD-1 inhibitors among patients with advanced non-small cell lung cancer (NSCLC). METHODS: The PICOs (participants, intervention, comparison, and outcomes) elements were used for the selection of studies to meet the inclusion and exclusion criteria. Google Scholar, PubMed, Science Direct and proceedings of major oncology conferences were systematically searched from their inception to December 2020, to identify studies which reported the GI adverse events of PD-1 inhibitors among patients with NSCLC. Risks of bias were assessed by using a revised methodological index for nonrandomized studies (MINORS). Pooled incidences and weighted relative risk (RR) estimate for GI adverse events, the incidence of treatment discontinuation due to GI adverse events was also calculated. To perform the analysis of qualified studies, the model of random effects was used and the inconsistency of studies with the I2 index was investigated. OpenMeta 10.10, Stata 11.0 and RevMan 5.3 software were used for data analysis. RESULTS: The research included 15 studies comprising of a total of 3,716 patients. The incidences of all-grade GI symptoms were: diarrhea 8.6% (95% CI: 6.6–10.6%), nausea 9.2% (95% CI: 7.3–11.0%), vomiting 3.2% (95% CI: 1.9–4.5%), constipation 2.8% (95% CI: 1.8–3.9%), colitis 0.7% (95% CI: 0.4–1.1%), stomatitis (95% CI: 1.0–2.7%), and decreased appetite 10.0% (95% CI: 8.3–11.7%). Therapy using PD-1 inhibitors was discontinued in 2.5% (95% CI: 0.0–5.1%) of patients with nausea, in 3.0% (95% CI: 0.7–5.3%) of those with diarrhea, and in 45.7% (95% CI: 20.6–70.7%) of patients with colitis. Compared with chemotherapy, the use of PD-1 inhibitors showed significant increase in the occurrence of grade 1–4 colitis (RR =3.90, 95% CI: 1.41–10.81, P=0.009) and grade 3–4 colitis (RR =3.76, 95% CI: 1.07–13.26, P=0.04). DISCUSSION: This meta-analysis provides a reliable estimate of the incidences of GI adverse events among NSCLC patients. Especially when colitis does occur, it often results in therapy discontinuation. Use of PD-1 inhibitors led to a higher incidence of colitis as compared to the use of chemotherapy. |
format | Online Article Text |
id | pubmed-8798015 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-87980152022-02-02 The incidence of gastrointestinal adverse events in patients with advanced non-small cell lung cancer (NSCLC) treated with PD-1 inhibitors: a meta-analysis Huo, Geng-Wei Zhu, Fu-Yi Zuo, Ran Song, Ying Chen, Wei-Dong Chen, Wen-Ming Zhang, Hong-Mei Jia, Sha-Sha Chen, Peng Transl Cancer Res Original Article BACKGROUND: We conducted a meta-analysis to evaluates the incidence of the gastrointestinal (GI) adverse events with the use of PD-1 inhibitors among patients with advanced non-small cell lung cancer (NSCLC). METHODS: The PICOs (participants, intervention, comparison, and outcomes) elements were used for the selection of studies to meet the inclusion and exclusion criteria. Google Scholar, PubMed, Science Direct and proceedings of major oncology conferences were systematically searched from their inception to December 2020, to identify studies which reported the GI adverse events of PD-1 inhibitors among patients with NSCLC. Risks of bias were assessed by using a revised methodological index for nonrandomized studies (MINORS). Pooled incidences and weighted relative risk (RR) estimate for GI adverse events, the incidence of treatment discontinuation due to GI adverse events was also calculated. To perform the analysis of qualified studies, the model of random effects was used and the inconsistency of studies with the I2 index was investigated. OpenMeta 10.10, Stata 11.0 and RevMan 5.3 software were used for data analysis. RESULTS: The research included 15 studies comprising of a total of 3,716 patients. The incidences of all-grade GI symptoms were: diarrhea 8.6% (95% CI: 6.6–10.6%), nausea 9.2% (95% CI: 7.3–11.0%), vomiting 3.2% (95% CI: 1.9–4.5%), constipation 2.8% (95% CI: 1.8–3.9%), colitis 0.7% (95% CI: 0.4–1.1%), stomatitis (95% CI: 1.0–2.7%), and decreased appetite 10.0% (95% CI: 8.3–11.7%). Therapy using PD-1 inhibitors was discontinued in 2.5% (95% CI: 0.0–5.1%) of patients with nausea, in 3.0% (95% CI: 0.7–5.3%) of those with diarrhea, and in 45.7% (95% CI: 20.6–70.7%) of patients with colitis. Compared with chemotherapy, the use of PD-1 inhibitors showed significant increase in the occurrence of grade 1–4 colitis (RR =3.90, 95% CI: 1.41–10.81, P=0.009) and grade 3–4 colitis (RR =3.76, 95% CI: 1.07–13.26, P=0.04). DISCUSSION: This meta-analysis provides a reliable estimate of the incidences of GI adverse events among NSCLC patients. Especially when colitis does occur, it often results in therapy discontinuation. Use of PD-1 inhibitors led to a higher incidence of colitis as compared to the use of chemotherapy. AME Publishing Company 2021-07 /pmc/articles/PMC8798015/ /pubmed/35116644 http://dx.doi.org/10.21037/tcr-21-125 Text en 2021 Translational Cancer Research. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/. |
spellingShingle | Original Article Huo, Geng-Wei Zhu, Fu-Yi Zuo, Ran Song, Ying Chen, Wei-Dong Chen, Wen-Ming Zhang, Hong-Mei Jia, Sha-Sha Chen, Peng The incidence of gastrointestinal adverse events in patients with advanced non-small cell lung cancer (NSCLC) treated with PD-1 inhibitors: a meta-analysis |
title | The incidence of gastrointestinal adverse events in patients with advanced non-small cell lung cancer (NSCLC) treated with PD-1 inhibitors: a meta-analysis |
title_full | The incidence of gastrointestinal adverse events in patients with advanced non-small cell lung cancer (NSCLC) treated with PD-1 inhibitors: a meta-analysis |
title_fullStr | The incidence of gastrointestinal adverse events in patients with advanced non-small cell lung cancer (NSCLC) treated with PD-1 inhibitors: a meta-analysis |
title_full_unstemmed | The incidence of gastrointestinal adverse events in patients with advanced non-small cell lung cancer (NSCLC) treated with PD-1 inhibitors: a meta-analysis |
title_short | The incidence of gastrointestinal adverse events in patients with advanced non-small cell lung cancer (NSCLC) treated with PD-1 inhibitors: a meta-analysis |
title_sort | incidence of gastrointestinal adverse events in patients with advanced non-small cell lung cancer (nsclc) treated with pd-1 inhibitors: a meta-analysis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8798015/ https://www.ncbi.nlm.nih.gov/pubmed/35116644 http://dx.doi.org/10.21037/tcr-21-125 |
work_keys_str_mv | AT huogengwei theincidenceofgastrointestinaladverseeventsinpatientswithadvancednonsmallcelllungcancernsclctreatedwithpd1inhibitorsametaanalysis AT zhufuyi theincidenceofgastrointestinaladverseeventsinpatientswithadvancednonsmallcelllungcancernsclctreatedwithpd1inhibitorsametaanalysis AT zuoran theincidenceofgastrointestinaladverseeventsinpatientswithadvancednonsmallcelllungcancernsclctreatedwithpd1inhibitorsametaanalysis AT songying theincidenceofgastrointestinaladverseeventsinpatientswithadvancednonsmallcelllungcancernsclctreatedwithpd1inhibitorsametaanalysis AT chenweidong theincidenceofgastrointestinaladverseeventsinpatientswithadvancednonsmallcelllungcancernsclctreatedwithpd1inhibitorsametaanalysis AT chenwenming theincidenceofgastrointestinaladverseeventsinpatientswithadvancednonsmallcelllungcancernsclctreatedwithpd1inhibitorsametaanalysis AT zhanghongmei theincidenceofgastrointestinaladverseeventsinpatientswithadvancednonsmallcelllungcancernsclctreatedwithpd1inhibitorsametaanalysis AT jiashasha theincidenceofgastrointestinaladverseeventsinpatientswithadvancednonsmallcelllungcancernsclctreatedwithpd1inhibitorsametaanalysis AT chenpeng theincidenceofgastrointestinaladverseeventsinpatientswithadvancednonsmallcelllungcancernsclctreatedwithpd1inhibitorsametaanalysis AT huogengwei incidenceofgastrointestinaladverseeventsinpatientswithadvancednonsmallcelllungcancernsclctreatedwithpd1inhibitorsametaanalysis AT zhufuyi incidenceofgastrointestinaladverseeventsinpatientswithadvancednonsmallcelllungcancernsclctreatedwithpd1inhibitorsametaanalysis AT zuoran incidenceofgastrointestinaladverseeventsinpatientswithadvancednonsmallcelllungcancernsclctreatedwithpd1inhibitorsametaanalysis AT songying incidenceofgastrointestinaladverseeventsinpatientswithadvancednonsmallcelllungcancernsclctreatedwithpd1inhibitorsametaanalysis AT chenweidong incidenceofgastrointestinaladverseeventsinpatientswithadvancednonsmallcelllungcancernsclctreatedwithpd1inhibitorsametaanalysis AT chenwenming incidenceofgastrointestinaladverseeventsinpatientswithadvancednonsmallcelllungcancernsclctreatedwithpd1inhibitorsametaanalysis AT zhanghongmei incidenceofgastrointestinaladverseeventsinpatientswithadvancednonsmallcelllungcancernsclctreatedwithpd1inhibitorsametaanalysis AT jiashasha incidenceofgastrointestinaladverseeventsinpatientswithadvancednonsmallcelllungcancernsclctreatedwithpd1inhibitorsametaanalysis AT chenpeng incidenceofgastrointestinaladverseeventsinpatientswithadvancednonsmallcelllungcancernsclctreatedwithpd1inhibitorsametaanalysis |