Decoding the Complex Interplay of Immune Checkpoint and Angiogenesis Inhibitors
When it comes to treating advanced lung cancer, the combination of Immune Checkpoint Inhibitors (ICIs) and Angiogenesis Inhibitors has been a game-changer. But what about the risks? A recent systematic review and meta-analysis dives deep into this question.
The study, published in International Immunopharmacology, aims to provide a comprehensive overview of the treatment-related adverse events (trAEs) associated with this drug combination.
The Source Article Details
Treatment-related adverse events of immune checkpoint inhibitors combined with angiogenesis inhibitors in advanced lung cancer: A systematic review and meta-analysis by Yumin Zheng et al. in 2023.
The Source Article's Abstract
Immune checkpoint inhibitors (ICIs) with angiogenesis inhibitors have been used to treat advanced lung cancer. Their associated treatment-related adverse events (trAEs) are currently considered acceptable; however, no conclusion has been reached.
Pulled studies met the following criteria: patients with advanced lung cancer who received treatment involving ICIs combined with angiogenesis inhibitors (with or without chemotherapy) in interventional or observational studies.
The study enrolled 32 trials involving 2313 patients who had 7768 any-grade trAEs and 1078 grade ≥3 trAEs. The pooled incidences were 87.33% (95% confidence interval [CI]: 79.49-93.65; I2 = 94.04%) for any-grade trAEs, and 38.63% (95% CI: 28.28-49.50; I2 = 95.61%) for grade ≥3 trAEs. There were 132 kinds of any-grade trAEs involving 18 systems, and 99 kinds of grade ≥3 trAEs involving 16 systems. For all trAEs, we observed significant differences in the line of therapy, trial design, therapy combination, and types of angiogenesis inhibitors (all P < 0.05). The rate of trAEs increased with dosage and frequency of medication. Pooled incidences of discontinuation and mortality were 10.64% and 0.81%, respectively. Nearly 647 patients experienced irAEs, including 636 any-grade irAEs and 154 grade ≥3 irAEs.
Overall, the incidence of trAEs caused by ICIs combined with angiogenesis inhibitors is generally acceptable. These trAEs have a wide spectrum nearly covering the full range of adverse events. Grade ≥3 trAEs are more closely associated with angiogenesis inhibitors than any grade. However, treatment-associated mortality remains concerning.
The Source Article References
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Citing the Source Article (APA)
Zheng, Y., Dong, H., Yu, Y., Hu, Z., Xue, C., Zhang, X., Cui, H. (2023). Treatment-related adverse events of immune checkpoint inhibitors combined with angiogenesis inhibitors in advanced lung cancer: A systematic review and meta-analysis. International Immunopharmacology, 123, 110785-110785. 10.1016/j.intimp.2023.110785
What the Numbers Say: A Statistical Overview
The study enrolled 32 trials involving 2313 patients and found a significant number of trAEs. The pooled incidences were 87.33% for any-grade trAEs and 38.63% for grade ≥3 trAEs.
These numbers are not just digits; they are a crucial insight into the safety profile of these treatments. The rate of trAEs increased with dosage and frequency of medication, a critical point for clinicians to note.
PP-ICONS: Evaluating the Evidence
- Problem: Treatment-related adverse events in advanced lung cancer.
- Patient or Population: Patients with advanced lung cancer.
- Intervention: Combination of ICIs and Angiogenesis Inhibitors.
- Comparison: Not specified.
- Outcome: Incidence of trAEs.
- Number of Subjects: 2313 patients.
- Statistics: Pooled incidences and confidence intervals.
Implications for the Medical Profession
The study concludes that the incidence of trAEs is generally acceptable but raises concerns about treatment-associated mortality. This information is invaluable for oncologists and pharmacologists who are on the frontline of treating advanced lung cancer.
However, the study also indicates that grade ≥3 trAEs are more closely associated with angiogenesis inhibitors than any grade. This finding could influence future treatment protocols and patient counseling.
What’s Your Take?
As medical professionals, how do you weigh the benefits against the risks when it comes to combining ICIs and Angiogenesis Inhibitors? Are the adverse events a necessary evil for the greater good of effective treatment?
We’d love to hear your thoughts. Feel free to leave a comment below.