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Immune-related adverse events: promising predictors for efficacy of immune checkpoint inhibitors

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Abstract

Purpose

This study was designed to investigate the correlation between immune-related adverse events (irAEs) of immune checkpoint inhibitors (ICIs) and corresponding efficacy, and to explore the potential of predicting the efficacy of ICIs via irAEs.

Methods

Electronic databases including PubMed, Embase, Cochrane Library, CNKI and Wanfang were applied to search for relevant studies. The primary endpoint was overall survival (OS) or progression-free survival (PFS), and the secondary endpoint was objective response rate (ORR). Stratification analyses were conducted according to the type of irAEs and ICIs, region of studies and primary tumors. Furthermore, statistical analyses were realized by means of RevMan 5.3 software.

Results

Altogether, 40 studies with 8,641 participants were enrolled, among which the incidence of irAEs ranged from 15.34 to 85.23% and the major sites reached out to skin, endocrine organ, gastrointestinal tract, liver and lung. The ORR, OS and PFS in irAE group were significantly higher than those in non-irAE group as per pooled analyses and stratification analyses. Importantly, patients with irAEs in skin, endocrine organ or gastrointestinal tract rather than in liver and lung were found to obtain survival benefits (p < 0.05).

Conclusion

IrAEs, especially in skin, endocrine organ or gastrointestinal tract, triggered by ICIs indicate significant survival benefits.

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Funding

This work was supported by the Natural Science Foundation of Fujian Province (2019J01457).

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Authors and Affiliations

  1. Department of Oncology, The First Affiliated Hospital of Fujian Medical University, No. 20 Chazhong Road, Taijiang District, Fuzhou, 350005, China

    Li Zhong, Qing Wu, Junjin Liu & Xianhe Xie

  2. Department of Oncology, The Second Hospital of Longyan, Fujian, 364000, China

    Li Zhong

  3. Department of Gynecology, The First Hospital of Longyan, Fujian, 364000, China

    Fuchun Chen

  4. Molecular Oncology Research Institute, First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China

    Xianhe Xie

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  1. Li Zhong
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  2. Qing Wu
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  4. Junjin Liu
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Contributions

Conceptualization: XX and LZ; methodology: LZ and JL; software: LZ; validation: all authors; formal analysis: LZ, FC and XX; data curation: LZ; writing—original draft preparation: LZ, QW and XX; writing—review and editing: all authors; visualization: LZ; supervision: XX.

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Correspondence to Xianhe Xie.

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Zhong, L., Wu, Q., Chen, F. et al. Immune-related adverse events: promising predictors for efficacy of immune checkpoint inhibitors. Cancer Immunol Immunother 70, 2559–2576 (2021). https://doi.org/10.1007/s00262-020-02803-5

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