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Meta-analysis

Toxicity patterns associated with chemotherapy/immune checkpoint inhibitor combinations: a meta-analysis

    Omar Abdel-Rahman

    *Author for correspondence:

    E-mail Address: omar.abdelsalam@ahs.ca

    Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, Alberta, Canada

    Search for more papers by this author

    Published Online:12 Mar 2019https://doi.org/10.2217/imt-2018-0186

    Abstract

    Aim: This study aims to clarify toxicity patterns associated with chemotherapy/immune checkpoint inhibitor combinations. Methods: Eligible studies included randomized studies evaluating chemotherapy with or without an immune checkpoint inhibitor (including pembrolizumab, nivolumab, atezolizumab, durvalumab or avelumab). The primary summary statistic was the relative risk (RR). Results: A total of 11 studies were finally included into this meta-analysis. RRs of high-grade anemia, thrombocytopenia and neutropenia were 0.98 (95% CI: 0.83–1.16; p = 0.84), 1.10 (95% CI: 0.83–1.47; p = 0.51) and 0.96 (0.78–1.17; p = 0.66), respectively. RR of high-grade nausea, vomiting and diarrhea was 1.19 (95% CI: 0.78–1.82; p = 0.42), 1.09 (95% CI: 0.69–1.72; p = 0.71) and 2.61 (1.42–4.79; p = 0.002), respectively. Conclusion: Addition of immune checkpoint inhibitors to chemotherapy backbone does not increase the risk of high-grade hematological or gastrointestinal toxicities (except for high-grade diarrhea).

    Papers of special note have been highlighted as: • of interest; •• of considerable interest

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