Risk of Cutaneous Toxicities in Patients with Solid Tumors Treated with Immune Checkpoint Inhibitors: A Meta-Analysis

Abdel‐Rahman, Omar; Elhalawani, Hesham; Fouad, Mona

doi:10.2217/fon.15.118

Cited by 70 publications

(47 citation statements)

References 40 publications

(46 reference statements)

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“…[17,18] In light of the growing clinical importance of PD-1 directed antibodies as exemplified by the publication of numerous randomized trials in 2015, we conducted a comprehensive systematic review and meta-analysis to refine the understand and assessment of the risk of AEs associated with approved PD-1 inhibitors (nivolumab and pembrolizumab) in patients with solid tumors. As a meta-analysis of large randomized clinical trials this study particularly improves the precision of prevalence estimates of potentially irAEs in these patients.…”

Section: Discussionmentioning

confidence: 99%

Toxicity profile of approved anti-PD1 monoclonal antibodies in solid tumors: A systematic review and meta-analysis of randomized clinical trials.

Costa

Carneiro²,

Rademaker

et al. 2016

JCO

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Purpose: Nivolumab and pembrolizumab are antibodies against the programmeddeath-receptor-1 (PD-1) which are associated with distinct immune related adverse effects (AEs). This meta-analysis of randomized clinical trials aims to summarize current knowledge regarding the toxicity profile of these agents.Methods: PubMed search was conducted in February of 2016. The randomized trials needed to have at least one of the study arms consisting of nivolumab or pembrolizumab monotherapy and a control arm containing no anti-PD-1 therapy. Data were analyzed using random effects meta-analysis for risk ratios. Heterogeneity across studies was analyzed using Q and I

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Section: Discussionmentioning

confidence: 99%

Toxicity profile of approved anti-PD1 monoclonal antibodies in solid tumors: A systematic review and meta-analysis of randomized clinical trials.

Costa

Carneiro²,

Rademaker

et al. 2016

JCO

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“…A second meta-analysis from a total of nine clinical trials in patients receiving ipilimumab, nivolumab, tremelimumab, pidlizumab, and pembrolizumab was included. The relative risk of all-grade rash was 4.06 (95% CI: 3.35-4.91; P < 0.0001), vitiligo 16.3 (95% CI: 3.21-82.8; P = 0.0008), and pruritus was 3.4 (95% CI: 2.24-5.16; P < 0.00001) [22]. Immunotherapy -Myths, Reality, Ideas, Future…”

Section: Dermatologicalmentioning

confidence: 98%

Management and Supportive Care of Patients Undergoing Immunotherapy

Rapoport¹,

Eeden²

2017

Immunotherapy - Myths, Reality, Ideas, Future

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In many tumor types, where the prognosis was shown to be extremely dismal before, immunotherapy is now a new beacon of hope to many patients. Immunotherapy has been approved for use in a many diferent cancers including metastatic melanoma, advanced non-small cell lung cancer, metastatic renal cell carcinoma, refractory Hodgkin's lymphoma, metastatic bladder cancer advanced head and neck cancer, and the list keeps growing each day. It seems to be generally beter tolerated in most patients and less toxic compared to what we have seen in diferent anticancer treatments from before. However, the toxicities here are termed immune-related adverse events. There is almost no prospective data on these toxicities, and guidelines or recommendations are mostly based on symptomatic management from the ongoing clinical trials. Treating oncologists need to be aware of the subtleties in presentation and the huge diference in the way we mange these side efects. Although most adverse events are low-grade and manageable, they have the potential to be life-threatening if not treated promptly. In this chapter, we address the diferent immune-related adverse events relating to the organ system they can involve, presentation and symptomatology, general recommendations of management, and individual toxicities. Keywords: immunotherapy, PD-1, CTLA-4.

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“…None of the patients in the NSCLC studies received high-dose methylprednisolone or equivalent to resolve skin reactions. Intermittent or permanent discontinuation of the PD-1 inhibitor was rarely necessary [27].…”

Section: Skin Toxicitymentioning

confidence: 99%

Checkpoint Inhibitors in Breast Cancer - Current Status and Future Directions

Bischoff¹

2018

Breast Care

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Antineoplastic agents directly targeting tumor cells have represented the major strategy of systemic anticancer therapy for many years. Nevertheless, overcoming resistance mechanisms remains a great challenge because treatment options are limited in many cases. From this point of view, immunotherapeutic approaches seem promising in a broad spectrum of solid tumors. These include in particular the currently available inhibitors directed against immune checkpoints leading to a significant T-cell activation. To date, the programmed death receptor 1 (PD-1) and its ligand are the most prominent targets in this context. However, the role of checkpoint inhibitors in the treatment of breast cancer is still being debated, and the main focus is on triple-negative breast cancer patients as a target population in many ongoing trials. Moreover, the potential superiority of combinations with other anticancer drugs such as cytotoxics and targeted agents will be discussed.

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Risk of Cutaneous Toxicities in Patients with Solid Tumors Treated with Immune Checkpoint Inhibitors: A Meta-Analysis

Abstract: Our meta-analysis demonstrates that immune checkpoint inhibitors are associated with an increased risk of all grade skin rash, vitiligo and pruritus. Clinicians should perform regular clinical cutaneous monitoring.

Cited by 70 publications

References 40 publications

Toxicity profile of approved anti-PD1 monoclonal antibodies in solid tumors: A systematic review and meta-analysis of randomized clinical trials.

Toxicity profile of approved anti-PD1 monoclonal antibodies in solid tumors: A systematic review and meta-analysis of randomized clinical trials.

Management and Supportive Care of Patients Undergoing Immunotherapy

Checkpoint Inhibitors in Breast Cancer - Current Status and Future Directions

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