A large scale meta analysis identifies common adverse events with checkpoint inhibitors vs chemotherapy in melanoma patients.


Department of Clinical Laboratory, Guizhou Provincial People's Hospital, The Affiliated Hospital of Guizhou University, Guiyang, Guizhou Province 550000, China. Electronic address: [Email]


BACKGROUND : A meta-analysis was performed to assess the risk of common adverse events in melanoma patients treated with checkpoint inhibitors.
METHODS : Eligible studies were downloaded from PubMed, Embase, and Cochrane databases based on an established strategy. Review manager version 5.3 was used to analyze data.
RESULTS : After exclusion of ineligible studies, six studies were finally included in the meta-analysis, which comprised of 2136 patients in intervention group and 1773 patients in control group. There was a difference in low grade risk of pruritus (OR 5.63, 95% CI 2.92-10.85, P < 0.00001), diarrhea/colitis (OR 1.51, 95% CI 1.09-2.09, P = 0.01), but not fatigue (low grade, OR 0.96, 95% CI 0.72-1.29, P = 0.80; high grade, OR 0.72, 95% CI 0.23-2.24, P = 0.57) and some high grade risk between the intervention group and control group. Subgroups analysis revealed that low grade risk of pruritus (OR 8.17, 95% CI 4.29-15.55, P < 0.00001) and high grade risk of pruritus (OR 7.08, 95% CI 1.25-40.09, P = 0.03) were significantly different between patients treated with chemotherapy and those treated with checkpoint inhibitors. But fatigue and diarrhea/colitis were not different between the two groups.
CONCLUSIONS : Checkpoint inhibitors are associated with a higher risk in some side effects than chemotherapy in melanoma patients. Therefore, strategies that reduce the risk of adverse events in patients taking checkpoint inhibitors should be developed.


Adverse effect,Checkpoint inhibitor,Immunotherapy,Melanoma,

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