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Incidence of Pneumonitis With Use of Programmed Death 1 and Programmed Death-Ligand 1 Inhibitors in Non-Small Cell Lung Cancer

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Authors
Khunger, Monica
Rakshit, Sagar
Pasupuleti, Vinay
Hernandez, Adrian V.
Mazzone, Peter
Stevenson, James
Pennell, Nathan A.
Velcheti, Vamsidhar
Issue Date
2017-08
Keywords
Immune-related adverse events
Immunotherapy
Meta-analysis
Non-small cell lung cancer
Antineoplastic agent
atezolizumabavelumab
CD274 protein, human
Durvalumab
Monoclonal antibody
Nivolumab
PDCD1 protein, human
Pembrolizumab
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xmlui.metadata.dc.contributor.email
velchev@ccf.org

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Citation
Incidence of Pneumonitis With Use of Programmed Death 1 and Programmed Death-Ligand 1 Inhibitors in Non-Small Cell Lung Cancer 2017, 152 (2):271 Chest
Publisher
Elsevier Inc
Journal
Chest
URI
http://hdl.handle.net/10757/622260
DOI
10.1016/j.chest.2017.04.177
Additional Links
http://linkinghub.elsevier.com/retrieve/pii/S0012369217308826
Abstract
Background Programmed death 1 (PD-1) programmed death-ligand 1 (PD-L1) inhibitors show significant clinical activity in non-small cell lung carcinoma (NSCLC). However, they are often associated with potentially fatal immune-mediated pneumonitis. Preliminary reports of trials suggest a difference in the rate of pneumonitis with PD-1 and PD-L1 inhibitors. We sought to determine the overall incidence of pneumonitis and differences according to type of inhibitors and prior chemotherapy use. Methods MEDLINE, Embase, and Scopus databases were searched up to November 2016. Rates of pneumonitis of any grade and grade ≥ 3 from all clinical trials investigating nivolumab, pembrolizumab, atezolizumab, durvalumab, and avelumab as single agents in NSCLC were collected. The incidence of pneumonitis across trials was calculated using DerSimonian-Laird random effects models. We compared incidences between PD-1 and PD-L1 inhibitors and between treatment naive and previously treated patients. Results Nineteen trials (12 with PD-1 inhibitors [n = 3,232] and 7 with PD-L1 inhibitors [n = 1,806]) were identified. PD-1 inhibitors were found to have statistically significant higher incidence of any grade pneumonitis compared with PD-L1 inhibitors (3.6%; 95% CI, 2.4%-4.9% vs 1.3%; 95% CI, 0.8%-1.9%, respectively; P =.001). PD-1 inhibitors were also associated with higher incidence of grade 3 or 4 pneumonitis (1.1%; 95% CI, 0.6%-1.7% vs 0.4%; 95% CI, 0%-0.8%; P =.02). Treatment naive patients had higher incidence of grade 1 through 4 pneumonitis compared with previously treated patients (4.3%; 95% CI, 2.4%-6.3% vs 2.8%; 95% CI, 1.7%- 4%; P =.03). Conclusions There was a higher incidence of pneumonitis with use of PD-1 inhibitors compared with PD-L1 inhibitors. Higher rate of pneumonitis was more common in treatment naive patients. © 2017 American College of Chest Physicians
Type
info:eu-repo/semantics/article
Rights
info:eu-repo/semantics/restrictedAccess
Language
eng
Description
El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.
ISSN
00123692
ae974a485f413a2113503eed53cd6c53
10.1016/j.chest.2017.04.177
Scopus Count
Collections
Medicina

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