| Title | Safety and Efficacy of the Rechallenge of Immune Checkpoint Inhibitors After Immune-Related Adverse Events in Patients With Cancer: A Systemic Review and Meta-Analysis |
| Authors | Zhao, Qing Zhang, Jianwei Xu, Lingyi Yang, Huaxia Liang, Naixin Zhang, Li Zhang, Fengchun Zhang, Xuan |
| Affiliation | Chinese Acad Med Sci & Peking Union Med Coll, Peking Union Med Coll Hosp, Dept Rheumatol & Clin Immunol, Beijing, Peoples R China Natl Clin Res Ctr Dermatol & Immunol Dis, Minist Educ, Key Lab, Beijing, Peoples R China Chinese Acad Med Sci & Peking Union Med Collage, Peking Union Med Coll Hosp, State Key Lab Complex Severe & Rare Dis, Beijing, Peoples R China Peking Univ Canc Hosp & Inst, Dept Gastrointestinal Oncol, Minist Educ Beijing, Key Lab Carcinogenesis & Translat Res, Beijing, Peoples R China Peking Univ, Peking Univ First Hosp, Inst Nephrol, Renal Div, Beijing, Peoples R China Chinese Acad Med Sci & Peking Union Med Coll, Peking Union Med Coll Hosp, Dept Thorac Surg, Beijing, Peoples R China Chinese Acad Med Sci & Peking Union Med Coll, Peking Union Med Coll Hosp, Dept Resp, Beijing, Peoples R China Chinese Acad Med Sci & Peking Union Med Coll, Med Epigenet Res Ctr, Clin Immunol Ctr, Beijing, Peoples R China |
| Keywords | ADVANCED MELANOMA IPILIMUMAB ANTI-PD-1 IMMUNOTHERAPY RETREATMENT ANTI-CTLA-4 MANAGEMENT NIVOLUMAB ANTIBODY THERAPY |
| Issue Date | 27-Sep-2021 |
| Publisher | FRONTIERS IN IMMUNOLOGY |
| Abstract | Introduction: Little evidence exists on the safety and efficacy of the rechallenge of immune checkpoint inhibitors (ICIs) after immune-related adverse events (irAEs) in patients with cancer. Methods: We searched PubMed, Web of Science, Embase, and Cochrane for articles on ICI rechallenge after irAEs for systemic review and meta-analysis. The outcomes included the incidence and associated factors for safety and objective response rate (ORR) and disease control rate (DCR) for efficacy. Results: A total of 789 ICI rechallenge cases from 18 cohort studies, 5 case series studies, and 54 case reports were included. The pooled incidence of all-grade and high-grade irAEs after rechallenge in patients with cancer was 34.2% and 11.7%, respectively. Compared with initial ICI treatment, rechallenge showed a higher incidence for all-grade irAEs (OR, 3.81; 95% CI, 2.15-6.74; p < 0.0001), but similar incidence for high-grade irAEs (p > 0.05). Types of initial irAEs (pneumonitis and global irAEs) and cancer (non-small cell lung cancer and multiple cancer) recapitulated these findings. Gastrointestinal irAEs and time interval between initial irAEs and ICI rechallenge were associated with higher recurrence of high-grade irAEs (p < 0.05), whereas initial anti-PD-1/PD-L1 antibodies were associated with a lower recurrence (p < 0.05). Anti-PD-1/PD-L1 antibodies rechallenge was associated with a lower all-grade irAE recurrence (p < 0.05). The pooled ORR and DCR after rechallenge were 43.1% and 71.9%, respectively, showing no significant difference compared with initial ICI treatment (p > 0.05). Conclusions: ICI rechallenge after irAEs showed lower safety and similar efficacy outcomes compared with initial ICI treatment. |
| URI | http://hdl.handle.net/20.500.11897/626723 |
| ISSN | 1664-3224 |
| DOI | 10.3389/fimmu.2021.730320 |
| Indexed | SCI(E) |
| Appears in Collections: | 北京肿瘤医院 第一医院 |
