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, MonicaRakshit, Sagar
Pasupuleti, Vinay
Hernandez, Adrian V.
Mazzone, Peter
Stevenson, James
Pennell, Nathan A.
Velcheti, Vamsidhar
Issue Date
2017-08Keywords
Immune-related adverse eventsImmunotherapy
Meta-analysis
Non-small cell lung cancer
Antineoplastic agent
atezolizumabavelumab
CD274 protein, human
Durvalumab
Monoclonal antibody
Nivolumab
PDCD1 protein, human
Pembrolizumab
xmlui.metadata.dc.contributor.email
[email protected]
Metadata
Show full item recordCitation
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 ChestPublisher
Elsevier IncJournal
ChestDOI
10.1016/j.chest.2017.04.177Additional Links
http://linkinghub.elsevier.com/retrieve/pii/S0012369217308826Abstract
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 PhysiciansType
info:eu-repo/semantics/articleRights
info:eu-repo/semantics/restrictedAccessLanguage
engDescription
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
00123692ae974a485f413a2113503eed53cd6c53
10.1016/j.chest.2017.04.177
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