Abstract 1357
Background
Among lung cancers, non- small cell lung cancer (NSCLC) accounts for approximately 80% of cases. It is one of the leading causes of cancer related mortality in US. Atezolizumab is a humanized monoclonal antibody against the programmed cell death-ligand 1 (PD-L1) protein. We have conducted a meta-analysis to evaluate the risk of first-line atezolizumab chemoimmunotherapy- associated immune-related adverse events (IRAEs) in patients with advanced NSCLC.
Methods
PUBMED, MEDLINE, EMBASE databases and meeting abstracts from inception through March 2019 were queried. Phase III RCTs that mention IRAEs as adverse effects were incorporated in the analysis. Mantel-Haenszel (MH) method was used to calculate the estimated pooled risk ratio (RR) with 95% confidence interval (CI). Random effects model was applied.
Results
A total of 2725 patients with advanced NSCLC from four phase III RCTs were eligible. The study arm used standard chemotherapy regimens in combination with atezolizumab while control arm utilized only standard chemotherapy regimens. The RR of all-grade side effects were as follows: rash, 1.68 (95% CI: 1.13 – 2.50, p = 0.01); hepatitis, 2.57 (95% CI: 1.21– 5.49; p = 0.01); hypothyroidism, 6.27 (95% CI: 2.55 – 15.44, p < 0.0001); hyperthyroidism, 3.95 (95% CI: 1.77– 8.78; p = 0.0008); pneumonitis, 3.29 (95% CI: 1.98– 5.46; p < 0.0001); and colitis, 5.02 (95% CI: 1.74–14.50; p = 0.003). The RR of high-grade side effects were as follows: rash, 2.70 (95% CI: 1.20 – 6.10, p = 0.02); hepatitis, 4.35 (95% CI: 1.80– 10.51; p = 0.001); hypothyroidism, 3.51 (95% CI: 0.75 – 16.46, p = 0.11); hyperthyroidism, 2.48 (95% CI: 0.50– 12.25; p = 0.27); pneumonitis, 1.63 (95% CI: 0.72– 3.72; p = 0.24); and colitis, 3.86 (95% CI: 1.19–12.53; p = 0.02).
Conclusions
Our meta-analysis showed that the addition of atezolizumab to standard chemotherapy, contributed to higher incidence of all grades of rash, hepatitis and colitis with RR of 4.35 for grade 3 and 4 hepatitis. They also increased the risk of all-grade hypothyroidism, hyperthyroidism and pneumonitis. Timely intervention with proper supportive care will enhance patients’ quality of life, ultimately affecting patients’ compliance.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3371 - Pulmonary Resectable Metastases of Osteosarcoma With Apatinib and CHemotherapy (PROACH):A Multi-Center Phase II Randomized Clinical Trial
Presenter: Qiyuan Bao
Session: Poster Display session 1
Resources:
Abstract
1666 - National Clinical-biological Prospective Cohort of Incident Cases of Aggressive Fibromatosis, AF (ALTITUDES)
Presenter: Thomas Ryckewaert
Session: Poster Display session 1
Resources:
Abstract
5531 - Health-related quality Of Life In patients with advanced Soft TIssue sarcomas treated with Chemotherapy: The HOLISTIC study
Presenter: Eugenie Younger
Session: Poster Display session 1
Resources:
Abstract
5568 - Assessing QUality of life and Experiences of diagnostic Trajectories of Sarcoma patients: The QUEST study protocol
Presenter: Vicky Soomers
Session: Poster Display session 1
Resources:
Abstract