Analysis of risk factors for immune-related adverse events induced by immune checkpoint inhibitor treatment in cancer: A comprehensive systematic review

被引:0
作者
Jayathilaka, Bishma [1 ,2 ,3 ]
Mian, Farah [1 ]
Cockwill, Jo [4 ]
Franchini, Fanny [3 ]
Au-Yeung, George [2 ,5 ]
Ijzerman, Maarten [2 ,3 ,6 ]
机构
[1] Peter MacCallum Canc Ctr, Pharm Dept, Melbourne, Vic, Australia
[2] Univ Melbourne, Fac Med Dent & Hlth Sci, Sir Peter MacCallum Dept Oncol, Melbourne, Vic, Australia
[3] Univ Melbourne, Fac Med Dent & Hlth Sci, Ctr Canc Res, Canc Hlth Serv Res Unit, Melbourne, Vic, Australia
[4] Victorian Comprehens Canc Ctr Alliance Canc, Consumer Advisory Comm, Melbourne, Vic, Australia
[5] Peter MacCallum Canc Ctr, Dept Med Oncol, Melbourne, Vic, Australia
[6] Erasmus Univ, Erasmus Sch Hlth Policy & Management, Rotterdam, Netherlands
关键词
Immune checkpoint inhibitors; Immune-related adverse events; Risk factors; ASSOCIATION; BLOCKADE;
D O I
10.1016/j.critrevonc.2024.104601
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Immune-related adverse events (irAE) pose challenges to the use of immune checkpoint inhibitors (ICI). While risk factors for irAE are emerging, most studies are small, retrospective analyses that seldom report on diverse cancers or rare irAE. This paper reports a systematic review that summarises literature on irAE risk factors across cancers and proposes a categorisation approach. Method: A systematic search was conducted in Medline OVID, Embase and Web of Science databases following PRISMA guidelines (CRD42022310127). Original research published in peer-reviewed journals between January 2017-Decmeber 2021 were selected. Eligible studies included patients with any cancer and evaluated any potential risk factor for any grade/type of irAE. Study design, sample size, and method for analysing association between irAE and risk factors were compared. Results: A total of 293 eligible studies containing 305,879 patients receiving ICI reported irAE in 58,291 patients (19.1 %). There were 221 retrospective, 55 prospective studies, and 17 systematic reviews/meta-analyses. Eighteen studies evaluated the predictive validity of models. Proposed risk factors were grouped based on common themes and underlying aetiology: 1) patient, 2) laboratory, 3) medical history, 4) cancer-related, 5) clinical score, 6) medications, and 7) imaging features. Opposing associations were reported between advancing age and irAE risk. Conclusion: This systematic review provides a comprehensive overview of evidence on irAE risk factors across a large patient population. Studies were heterogeneous resulting from variations in design, sample size and analysis method, and lack generalisability due to statistically underpowered evidence. We propose an approach to categorise potential irAE risk factors to support ongoing collaborative research.
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页数:9
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