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. 2023 May 22:14:1190001.
doi: 10.3389/fphar.2023.1190001. eCollection 2023.

Association between immune-related adverse events and immunotherapy efficacy in non-small-cell lung cancer: a meta-analysis

Li Lin  1 , Yu Liu  2 , Chen Chen  1 , Anhua Wei  2 , Wei Li  2
Affiliations

Association between immune-related adverse events and immunotherapy efficacy in non-small-cell lung cancer: a meta-analysis

Li Lin et al. Front Pharmacol. .

Abstract

Objective: Our study aimed to identify potential correlations between anti-tumor efficacy and immune-related adverse events (irAEs) in non-small-cell lung cancer (NSCLC). Methods: We conducted a comprehensive search of online electronic databases up to March 2023 to identify any correlations between irAEs and immune checkpoint inhibitor (ICI) efficacy in NSCLC. We used meta-analysis RevMan 5.3 software to calculate pooled results. Results: Our meta-analysis of 54 studies revealed that patients who experienced irAEs achieved a significantly higher objective response rate (p < 0.00001) and longer progression-free survival (PFS) (p < 0.00001) and overall survival (OS) (p < 0.00001) than those who did not experience irAEs. Additionally, patients with ≥2 irAEs had better PFS, whereas no significant difference was observed between patients with or without squamous cell carcinoma. Subgroup analysis of irAE types indicated that irAEs (thyroid dysfunction and gastrointestinal, skin, or endocrine irAEs) were associated with better PFS and OS. However, no significant differences were observed between patients with pneumonitis or hepatobiliary irAEs. Conclusion: Our study showed that the occurrence of irAEs was a strong predictor of survival efficacy in patients with NSCLC treated with ICIs. Specifically, patients with ≥2 irAEs and those with thyroid dysfunction and gastrointestinal, skin, or endocrine irAEs achieved a better survival benefit. Systematic Review Registration: Website: https://www.crd.york.ac.uk/prospero/, Identifier: CRD42023421690.

Keywords: clinical efficacy; immune checkpoint inhibitors; immune-related adverse events; meta-analysis; non-small-cell lung cancer.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
PRISMA flow chart of the selection process to identify studies eligible for pooling.
FIGURE 2
FIGURE 2
Analysis of OS between IrAEs and ICI efficacy.
FIGURE 3
FIGURE 3
Sub-group analysis of OS between IrAEs and ICI efficacy with the number of irAEs.
FIGURE 4
FIGURE 4
Sub-group analysis of OS between IrAEs and ICI efficacy with types of irAEs.
FIGURE 5
FIGURE 5
Sub-group analysis of OS between IrAEs and ICI efficacy with pathological subtypes of irAEs.
FIGURE 6
FIGURE 6
Analysis of PFS between IrAEs and ICI efficacy.
FIGURE 7
FIGURE 7
Sub-group analysis of PFS between IrAEs and ICI efficacy with the number of irAEs.
FIGURE 8
FIGURE 8
Sub-group analysis of PFS between IrAEs and ICI efficacy with types of irAEs.
FIGURE 9
FIGURE 9
Sub-group analysis of PFS between IrAEs and ICI efficacy with pathological subtypes.
FIGURE 10
FIGURE 10
Analysis of ORR between IrAEs and ICI efficacy.
FIGURE 11
FIGURE 11
Funnel plot of OS, PFS, and ORR.
See this image and copyright information in PMC

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