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Meta-Analysis
. 2021 Jun 4;13(11):15413-15432.
doi: 10.18632/aging.203100. Epub 2021 Jun 4.

Sex-related differences in the efficacy of immune checkpoint inhibitors in malignancy: a systematic review and meta-analysis

Li-Ting Lai  1 , Wei-Guo Gu  1 , Ming-Bin Hu  1 , Wei-Jia Wang  2 , Shan-Shan Wang  2 , Ya-Jun Huai  1 , Jin-Hong Mei  2 , Chun-Liang Wang  3
Affiliations
Meta-Analysis

Sex-related differences in the efficacy of immune checkpoint inhibitors in malignancy: a systematic review and meta-analysis

Li-Ting Lai et al. Aging (Albany NY). .

Abstract

Although disease susceptibility is known to differ between men and women, it is controversial whether the efficacy of immune checkpoint inhibitors for malignancies also differs between the sexes. We conducted a meta-analysis to explore the impact of sex on immune checkpoint inhibitor treatment outcomes. We searched PubMed, Embase and the Cochrane Library databases from inception to October 1, 2020 for randomized controlled trials of immune checkpoint inhibitors with hazard ratios (HRs) stratified by sex. We calculated the pooled HRs for men and women using the ln(HR), and assessed the heterogeneity between the two estimates through an interaction test. In total, 22,268 patients from 39 randomized controlled trials were included. Immune checkpoint inhibitors yielded better overall survival than conventional agents in both men (HR: 0.75, 95% confidence interval [CI]: 0.71-0.80) and women (HR: 0.77, 95% CI: 0.70-0.85). Progression-free survival benefits were also observed in both men (HR: 0.64, 95% CI: 0.58-0.70) and women (HR: 0.67, 95% CI: 0.58-0.77) treated with immune checkpoint inhibitors. No sex differences in the response to immune checkpoint inhibitors were found when overall survival and progression-free survival were used as the endpoints.

Keywords: cancer; immunotherapy; meta-analysis; sex-specific differences; therapeutic efficacy.

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Conflict of interest statement

CONFLICTS OF INTEREST: The authors declare no conflicts of interest related to this study.

Figures

Figure 1
Figure 1
Overall survival hazard ratio in male patients in the immune checkpoint inhibitor group compared with the control group.
Figure 2
Figure 2
Overall survival hazard ratio in female patients in the immune checkpoint inhibitor group compared with the control group.
Figure 3
Figure 3
Progression-free survival hazard ratio in male patients in the immune checkpoint inhibitor group compared with the control group.
Figure 4
Figure 4
Progression-free survival hazard ratio in female patients in the immune checkpoint inhibitor group compared with the control group.
Figure 5
Figure 5
Subgroup analyses of overall survival in patients assigned to the intervention and control groups.
Figure 6
Figure 6
Subgroup analyses of progression-free survival in patients assigned to the intervention and control groups.
See this image and copyright information in PMC

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References

    1. Libert C, Dejager L, Pinheiro I. The X chromosome in immune functions: when a chromosome makes the difference. Nat Rev Immunol. 2010; 10:594–604. 10.1038/nri2815 - DOI - PubMed
    1. Case LK, Toussaint L, Moussawi M, Roberts B, Saligrama N, Brossay L, Huber SA, Teuscher C. Chromosome y regulates survival following murine coxsackievirus b3 infection. G3 (Bethesda). 2012; 2:115–21. 10.1534/g3.111.001610 - DOI - PMC - PubMed
    1. vom Steeg LG, Klein SL. SeXX Matters in Infectious Disease Pathogenesis. PLoS Pathog. 2016; 12:e1005374. 10.1371/journal.ppat.1005374 - DOI - PMC - PubMed
    1. Amadori A, Zamarchi R, De Silvestro G, Forza G, Cavatton G, Danieli GA, Clementi M, Chieco-Bianchi L. Genetic control of the CD4/CD8 T-cell ratio in humans. Nat Med. 1995; 1:1279–83. 10.1038/nm1295-1279 - DOI - PubMed
    1. Klein SL, Jedlicka A, Pekosz A. The Xs and Y of immune responses to viral vaccines. Lancet Infect Dis. 2010; 10:338–49. 10.1016/S1473-3099(10)70049-9 - DOI - PMC - PubMed

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