医学
内科学
肿瘤科
不利影响
肺癌
化疗
免疫疗法
皮疹
癌症
彭布罗利珠单抗
临床试验
癌
放射治疗
作者
Layal Rached,Ariane Laparra,Madona Sakkal,François‐Xavier Danlos,Fabrice Barlési,Franck Carbonnel,Eléonora De Martin,Michel Ducreux,C. Even,Jérôme Le Pavec,Jean‐Marie Michot,Joana M. Ribeiro,Florian Scotté,Santiago Ponce Aix,Olivier Lambotte,Capucine Baldini,Stéphane Champiat
标识
DOI:10.1016/j.ctrv.2024.102751
摘要
Chemotherapy associated with Immune Checkpoint Inhibitors is currently the standard of care in several tumor indications. This combination approach improves progression free survival (PFS), overall survival (OS) and complete pathological response (pCR) in several cancer types both in the early and metastatic approaches. However, the distinct spectrum of toxicities between cytotoxic side effects and immune related adverse events (irAEs) with similar clinical presentations and different management strategies remains a challenge in daily practice for healthcare professionals. This review summarizes the most common toxicities reported in the randomized clinical trials that led to the subsequent FDA approval of these combinations, across tumor indications. We cite in particular: non-small cell lung cancer, small cell lung cancer, triple negative breast cancer, squamous cell carcinoma of the head and neck, gastric carcinoma, esophageal carcinoma, cervical carcinoma and biliary tract carcinoma. We found that the combination of chemotherapy and immunotherapy was associated with an increased incidence of all grade adverse events (RR 1.11 [1.09; 1.12]) without an excess in treatment related mortality when compared to chemotherapy alone. We report also an increase in the incidence of serious adverse events (grade ≥ 3) (RR 1.16 [1.10;1.24]); in particular: high grade diarrhea, dyspnea, fatigue, rash and elevated liver enzymes. Together with the collaboration of our institutional network of organ specialists with expertise in irAEs, we propose practical recommendations for physicians to enhance clinical care and management of patients undergoing treatment with combined ICI immunotherapy and chemotherapy.
科研通智能强力驱动
Strongly Powered by AbleSci AI