Evidence map›Paper›PMID 28499515›Full record

SynthesisChest2017

Incidence of Pneumonitis With Use of Programmed Death 1 and Programmed Death-Ligand 1 Inhibitors in Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis of Trials.

Monica Khunger, Sagar Rakshit, Vinay Pasupuleti, Adrian V Hernandez, Peter Mazzone, James Stevenson, Nathan A Pennell, Vamsidhar Velcheti

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Chest, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 299 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
299citing papers in PubMed, 16 pooled it
–field-weighted citation impact
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

299 citing papers in PubMed, 16 syntheses or guidelines pooled it.

  1. The efficacy and safety of neoadjuvant immunochemotherapy in resectable stage I-III non-small cell lung cancer: a systematic review and network meta-analysis.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025
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  10. Small Cell Lung Cancer, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology.Journal of the National Comprehensive Cancer Network : JNCCN · 2021
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  18. A Phase 2 Study of Atezolizumab for Pretreated NSCLC With Idiopathic Interstitial Pneumonitis.Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer · 2020
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239 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Monica KhungerDepartment of Internal Medicine, Cleveland Clinic, Cleveland, OH.
Sagar RakshitDepartment of Internal Medicine, Cleveland Clinic, Cleveland, OH.
Vinay PasupuletiDepartment of Biostatistics, Case Western Reserve University, Cleveland, OH.
Adrian V HernandezUniversity of Connecticut/Hartford Hospital Evidence-based Practice Center, Hartford, CT; School of Medicine, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru.
Peter MazzoneRespiratory Institute, Cleveland Clinic, Cleveland, OH.
James StevensonDepartment of Hematology and Oncology, Tausig Cancer Institute, Cleveland Clinic, Cleveland, OH.
Nathan A PennellDepartment of Hematology and Oncology, Tausig Cancer Institute, Cleveland Clinic, Cleveland, OH.
Vamsidhar VelchetiDepartment of Hematology and Oncology, Tausig Cancer Institute, Cleveland Clinic, Cleveland, OH. Electronic address: velchev@ccf.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundProgrammed death 1 (PD-1) programmed death-ligand 1 (PD-L1) inhibitors show significant clinical activity in non-small cell lung carcinoma (NSCLC). However, they are often associated with potentially fatal immune-mediated pneumonitis. Preliminary reports of trials suggest a difference in the rate of pneumonitis with PD-1 and PD-L1 inhibitors. We sought to determine the overall incidence of pneumonitis and differences according to type of inhibitors and prior chemotherapy use.

methodsMEDLINE, Embase, and Scopus databases were searched up to November 2016. Rates of pneumonitis of any grade and grade ≥ 3 from all clinical trials investigating nivolumab, pembrolizumab, atezolizumab, durvalumab, and avelumab as single agents in NSCLC were collected. The incidence of pneumonitis across trials was calculated using DerSimonian-Laird random effects models. We compared incidences between PD-1 and PD-L1 inhibitors and between treatment naive and previously treated patients.

resultsNineteen trials (12 with PD-1 inhibitors [n = 3,232] and 7 with PD-L1 inhibitors [n = 1,806]) were identified. PD-1 inhibitors were found to have statistically significant higher incidence of any grade pneumonitis compared with PD-L1 inhibitors (3.6%; 95% CI, 2.4%-4.9% vs 1.3%; 95% CI, 0.8%-1.9%, respectively; P = .001). PD-1 inhibitors were also associated with higher incidence of grade 3 or 4 pneumonitis (1.1%; 95% CI, 0.6%-1.7% vs 0.4%; 95% CI, 0%-0.8%; P = .02). Treatment naive patients had higher incidence of grade 1 through 4 pneumonitis compared with previously treated patients (4.3%; 95% CI, 2.4%-6.3% vs 2.8%; 95% CI, 1.7%- 4%; P = .03).

conclusionsThere was a higher incidence of pneumonitis with use of PD-1 inhibitors compared with PD-L1 inhibitors. Higher rate of pneumonitis was more common in treatment naive patients.

Indexed as

AgedAntibodies, MonoclonalAntibodies, Monoclonal, HumanizedAntineoplastic AgentsB7-H1 AntigenCarcinoma, Non-Small-Cell LungClinical Trials, Phase I as TopicClinical Trials, Phase II as TopicClinical Trials, Phase III as TopicFemaleHumansImmunotherapyLung NeoplasmsMaleMiddle AgedNivolumabAntibodies, MonoclonalAntibodies, Monoclonal, HumanizedAntineoplastic AgentsatezolizumabavelumabB7-H1 AntigenCD274 protein, humandurvalumabNivolumabPDCD1 protein, humanpembrolizumabProgrammed Cell Death 1 Receptorimmune-related adverse eventsimmunotherapymeta-analysisnon-small cell lung cancerpneumonitis

Identifiers

PMID28499515

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.