Evidence map›Paper›PMID 28275115›Full record

SynthesisThe oncologist2017

Safety and Tolerability of PD-1/PD-L1 Inhibitors Compared with Chemotherapy in Patients with Advanced Cancer: A Meta-Analysis.

Tomohiro F Nishijima, Shlomit S Shachar, Kirsten A Nyrop, Hyman B Muss

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The oncologist, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 162 papers, 25 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
162citing papers in PubMed, 25 pooled it
15.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

162 citing papers in PubMed, 25 syntheses or guidelines pooled it, 300 citations in OpenAlex.

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  5. Immunotherapy for advanced or metastatic urothelial carcinoma.The Cochrane database of systematic reviews · 2023
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102 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 2 countries.

Tomohiro F NishijimaUNC Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA Tomohiro.Nishijima@unchealth.unc.edu.
Shlomit S ShacharDivision of Oncology, Rambam Health Care Campus, Haifa, Israel.
Kirsten A NyropUNC Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA.
Hyman B MussUNC Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA.
UNC Lineberger Comprehensive Cancer CenterRambam Health Care Campus · ILUniversity of North Carolina at Chapel Hill · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCompared with chemotherapy, significant improvement in survival outcomes with the programmed death receptor-1 (PD-1) inhibitors nivolumab and pembrolizumab and the programmed death-ligand 1 (PD-L1) inhibitor atezolizumab has been shown in several types of advanced solid tumors. We conducted a systematic review and meta-analysis to compare safety and tolerability between PD-1/PD-L1 inhibitors and chemotherapy.

methodsPubMed and American Society of Clinical Oncology (ASCO) databases were searched 1966 to September 2016. Eligible studies included randomized controlled trials (RCTs) comparing single-agent U.S. Food and Drug Administration-approved PD-1/PD-L1 inhibitors (nivolumab, pembrolizumab, or atezolizumab) with chemotherapy in cancer patients reporting any all-grade (1-4) or high-grade (3-4) adverse events (AEs), all- or high-grade treatment-related symptoms, hematologic toxicities and immune-related AEs, treatment discontinuation due to toxicities, or treatment-related deaths. The summary incidence, relative risk, and 95% confidence intervals were calculated.

resultsA total of 3,450 patients from 7 RCTs were included in the meta-analysis: 4 nivolumab, 2 pembrolizumab, and 1 atezolizumab trials. The underlying malignancies included were non-small cell lung cancer (4 trials) and melanoma (3 trials). Compared with chemotherapy, the PD-1/PD-L1 inhibitors had a significantly lower risk of all- and high-grade fatigue, sensory neuropathy, diarrhea and hematologic toxicities, all-grade anorexia, nausea, and constipation, any all- and high-grade AEs, and treatment discontinuation. There was an increased risk of all-grade rash, pruritus, colitis, aminotransferase elevations, hypothyroidism, and hyperthyroidism, and all- and high-grade pneumonitis with PD1/PD-L1 inhibitors.

conclusionPD-1/PD-L1 inhibitors are overall better tolerated than chemotherapy. Our results provide further evidence supporting the favorable risk/benefit ratio for PD-1/PD-L1 inhibitors.

Indexed as

Antibodies, MonoclonalAntibodies, Monoclonal, HumanizedB7-H1 AntigenCarcinoma, Non-Small-Cell LungDisease-Free SurvivalDrug-Related Side Effects and Adverse ReactionsHumansMelanomaNivolumabProgrammed Cell Death 1 ReceptorAntibodies, MonoclonalAntibodies, Monoclonal, HumanizedatezolizumabB7-H1 AntigenCD274 protein, humanNivolumabPDCD1 protein, humanpembrolizumabProgrammed Cell Death 1 ReceptorChemotherapyMeta‐analysisPD‐1/PD‐L1 inhibitorSystematic reviewToxicity

Identifiers

PMID28275115
PMCPMC5388381
OpenAlexW2591772299

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.