Evidence map›Paper›PMID 38291376›Full record

SynthesisBMC cancer2024

Discontinuation risk from adverse events: immunotherapy alone vs. combined with chemotherapy: a systematic review and network meta-analysis.

Sangwon Shin, Jimin Moon, Chiyoon Oum, Seulki Kim, Soo Ick Cho, Yoojoo Lim, Chan-Young Ock, Seunghwan Shin

Open access · goldAbstract readSystematic ReviewNetwork Meta-Analysis
In one paragraph

Synthesis in BMC cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.7field-weighted citation impact, top 14% 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

6 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Review
  3. Review
  4. Article
  5. Article
  6. Article
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

8 authors at 1 institution in 1 country.

Sangwon Shin *Lunit, 4th to 8th floors, 374, Gangnam-daero, Gangnam-gu, Seoul, Republic of Korea.
Jimin Moon *Lunit, 4th to 8th floors, 374, Gangnam-daero, Gangnam-gu, Seoul, Republic of Korea.
Chiyoon OumLunit, 4th to 8th floors, 374, Gangnam-daero, Gangnam-gu, Seoul, Republic of Korea.
Seulki KimLunit, 4th to 8th floors, 374, Gangnam-daero, Gangnam-gu, Seoul, Republic of Korea.
Soo Ick ChoLunit, 4th to 8th floors, 374, Gangnam-daero, Gangnam-gu, Seoul, Republic of Korea.
Yoojoo LimLunit, 4th to 8th floors, 374, Gangnam-daero, Gangnam-gu, Seoul, Republic of Korea.
Chan-Young OckLunit, 4th to 8th floors, 374, Gangnam-daero, Gangnam-gu, Seoul, Republic of Korea.
Seunghwan ShinLunit, 4th to 8th floors, 374, Gangnam-daero, Gangnam-gu, Seoul, Republic of Korea. ssh@lunit.io.
Luther University · KR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWhile immunotherapy combined with chemotherapy (Chemo-IO) is generally recognized for providing superior outcomes compared to monotherapy (mono-IO), it is associated with a higher incidence of treatment-related adverse events (TRAEs), which may lead to treatment discontinuation. In this study, we compared the rates of treatment discontinuation between mono-IO and Chemo-IO as first-line treatments for various solid tumors.

methodsWe systematically reviewed clinical trials from databases (PubMed, Embase, Cochrane Library, and an additional source) published from January 1, 2018, to July 10, 2023. We included phase III randomized controlled trials (RCTs) that utilized immunotherapy agents in at least one arm as first-line treatments for a variety of solid tumors. Data extraction followed the Preferred Reporting Items for Systematic Reviews (PRISMA) extension statement for network meta-analysis. A random effects model was used for the network meta-analysis, with the risk of bias assessed using the Cochrane risk-of-bias tool II. The primary outcomes encompassed treatment discontinuation rates due to TRAEs among patients who underwent immunotherapy, either alone or combined with chemotherapy, for various solid tumors. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated to compare between treatment groups.

resultsFrom 29 RCTs, a total of 21,677 patients and 5 types of treatment were analyzed. Compared to mono-IO, Chemo-IO showed a significantly higher rate of discontinuation due to TRAEs (RR 2.68, 95% CI 1.98-3.63). Subgroup analysis for non-small cell lung cancer (NSCLC) patients also exhibited a greater risk of discontinuation due to TRAEs with Chemo-IO compared to mono-IO (RR 2.93, 95% CI 1.67-5.14). Additional analyses evaluating discontinuation rates due to either treatment emergent adverse events (TEAEs) or AEs regardless of causality (any AEs) consistently revealed an elevated risk associated with Chemo-IO.

conclusionsChemo-IO was associated with an elevated risk of treatment discontinuation not only due to TRAEs but also any AEs or TEAEs. Given that the treatment duration can impact clinical outcomes, a subset of patients might benefit more from mono-IO than combination therapy. Further research is imperative to identify and characterize this subset.

Indexed as

Carcinoma, Non-Small-Cell LungLung NeoplasmsCombined Modality TherapyHumansImmunotherapyAdverse drug eventChemotherapyImmunotherapyNetwork meta-analysisTreatment-related adverse event

Identifiers

PMID38291376
PMCPMC10825980
OpenAlexW4391349928

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.