Endocrine adverse events in patients with cancer receiving perioperative immune checkpoint blockade: a meta-analysis of randomized controlled trials
| Autor: | Susu Zhou, Nobuyuki Horita, Theresa Shao, Matthew Harrington, Yu Fujiwara |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2024 |
| Předmět: | |
| Zdroj: | Therapeutic Advances in Medical Oncology, Vol 16 (2024) |
| Druh dokumentu: | article |
| ISSN: | 1758-8359 17588359 |
| DOI: | 10.1177/17588359241257874 |
| Popis: | Background: Perioperative use of immune checkpoint blockade (ICB) improves survival in patients with early-stage cancer. Treatment-related adverse events (AEs), frequently involve the endocrine system which may increase perioperative complications and affect quality of life. Objective: We conducted a meta-analysis to elucidate the impact of adding ICB to conventional neoadjuvant/adjuvant therapy on the incidence of endocrine AEs. Design: A systematic review and meta-analysis of randomize-controlled trials (RCTs). Data sources and methods: A systematic search of PubMed, Embase, Web of Science, and Cochrane library was performed for RCTs comparing groups with and without the addition of ICB to conventional perioperative therapy in patients with cancer. Outcomes included all-grade and grade 3–5 thyroiditis, hyperthyroidism, hypothyroidism, adrenal insufficiency, hypophysitis, type 1 diabetes mellitus, and hyperglycemia. The odds ratios (ORs) of all-grade and grade 3–5 endocrine were pooled using the random-effect model meta-analysis. Results: Twenty-four RCTs comprising 12,199 patients were identified for meta-analysis. The addition of ICB was associated with higher incidence of thyroiditis [all grade: OR = 3.53 (95% confidence interval (CI): 1.88–6.64)], hyperthyroidism [all-grade: 7.18 (4.30–12.01); grade 3–5: 3.93 (1.21–12.82)], hypothyroidism [all-grade: 5.39 (3.68–7.90); grade 3–5: 3.63 (1.18–11.11)], adrenal insufficiency [all-grade: 3.82 (1.88–7.79); grade 3–5: 5.91 (2.36–14.82)], hypophysitis [all-grade: 10.29 (4.97–21.3); grade 3–5: 5.80 (1.99–16.92)], and type 1 diabetes mellitus [all-grade: 2.24 (1.06–4.74); grade 3–5: 3.49 (1.21–10.08)]. The cumulative incidence of each grade 3–5 endocrine AE was low ( |
| Databáze: | Directory of Open Access Journals |
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