(Solid Tumors) Do Immune Checkpoint Inhibitors Have Lower Side Effects Than Chemotherapy?

• March 30, 2020
• Reading time: 2 minutes

Updated: April 13, 2020

On January 6, 2020, D.E. Magee published a meta-analysis in Annals of Oncology: "Adverse event profiles of immune checkpoint inhibitors — including anti-PD-1/PD-L1 and anti-CTLA-4 antibodies — versus standard chemotherapy in solid tumor patients."

Analysis Design

This meta-analysis included 22 Phase 2/3 clinical trials, covering solid tumor patients in both standard chemotherapy and immune checkpoint inhibitor (ICI) therapy groups (N=12,727). Primary endpoint: Grade 3+ adverse event rate. Secondary endpoints: overall adverse event rate, treatment discontinuation rate due to adverse events, and treatment-related mortality.

Results

Primary endpoint — Grade 3+ adverse event rate:

• ICI group: 16.5%
• Standard chemotherapy group: 41.09% — ICI group had significantly lower incidence.

Secondary endpoints: The ICI group had lower overall adverse event rates, lower treatment discontinuation rates due to adverse events, and lower treatment-related mortality rates — all compared to standard chemotherapy.

Comparative Adverse Event Rates

More common in chemotherapy group:

• Fatigue: Chemotherapy 25.10% / ICI 15.83%
• Diarrhea: Chemotherapy 14.97% / ICI 11.13%
• Acute kidney injury: Chemotherapy 1.79% / ICI 1.31%

More common in ICI group:

• Colitis: ICI 1.02% / Chemotherapy 0.26%
• Pneumonitis: ICI 3.36% / Chemotherapy 0.36%
• Hypothyroidism: ICI 6.82% / Chemotherapy 0.37%

Conclusions

Based on this meta-analysis, D.E. Magee concluded: In solid tumor patients, anti-PD-1/PD-L1 and anti-CTLA-4 immune checkpoint inhibitors demonstrated significantly lower Grade 3+ adverse event rates and treatment-related mortality compared to standard chemotherapy.

Source: Adverse event profile for immunotherapy agents compared with chemotherapy in solid organ tumors: a systematic review and meta-analysis of randomized clinical trials. Ann Oncol. 2020 Jan;31(1):50-60. doi: 10.1016/j.annonc.2019.10.008.

Tags: #SolidTumors #ImmuneCheckpointInhibitors

• Immunotherapy
• Clinical trial drug

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