Evidence map›Paper›PMID 38940446›Full record

SynthesisThe oncologist2024

Safety, efficacy, and survival outcomes of immune checkpoint inhibitors rechallenge in patients with cancer: a systematic review and meta-analysis.

Shi-Jia Liu, Lun-Jie Yan, Han-Chao Wang, Zi-Niu Ding, Hui Liu, Xiao Zhang, Guo-Qiang Pan, Cheng-Long Han, Bao-Wen Tian, Xiao-Rong Yang and 5 more

Erratum issuedAbstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in The oncologist, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 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

16 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  3. Type 3 Autoimmune Pancreatitis: What Do We Know So Far?Digestive diseases and sciences · 2026
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

Shi-Jia LiuDepartment of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, People's Republic of China.
Lun-Jie YanDepartment of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, People's Republic of China.
Han-Chao WangInstitute for Financial Studies, Shandong University, Jinan 250100, People's Republic of China.
Zi-Niu DingDepartment of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, People's Republic of China.
Hui LiuDepartment of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, People's Republic of China.
Xiao ZhangDepartment of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, People's Republic of China.
Guo-Qiang PanDepartment of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, People's Republic of China.
Cheng-Long HanDepartment of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, People's Republic of China.
Bao-Wen TianDepartment of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, People's Republic of China.
Xiao-Rong YangClinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan 250012, People's Republic of China.
Si-Yu TanDepartment of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, People's Republic of China.
Zhao-Ru DongDepartment of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, People's Republic of China.
Dong-Xu WangDepartment of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, People's Republic of China.
Yu-Chuan YanDepartment of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, People's Republic of China.
Tao LiDepartment of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, People's Republic of China.ORCID 0000-0002-5108-1774

Funding

National Natural Science Foundation of China 82073200Shandong Provincial Natural Science Foundation ZR202105070027Shandong Provincial Natural Science Foundation ZR2021ZD26Taishan Scholars Program of Shandong Province tstp20221158Universities in Jinan 2020GXRC023
6 · The paper itself

Abstract

backgroundsThere is little evidence on the safety, efficacy, and survival benefit of restarting immune checkpoint inhibitors (ICI) in patients with cancer after discontinuation due to immune-related adverse events (irAEs) or progressive disease (PD). Here, we performed a meta-analysis to elucidate the possible benefits of ICI rechallenge in patients with cancer.

methodsSystematic searches were conducted using PubMed, Embase, and Cochrane Library databases. The objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and incidence of irAEs were the outcomes of interest.

resultsThirty-six studies involving 2026 patients were analyzed. ICI rechallenge was associated with a lower incidence of all-grade (OR, 0.05; 95%CI, 0.02-0.13, P < .05) and high-grade irAEs (OR, 0.37; 95%CI, 0.21-0.64, P < .05) when compared with initial ICI treatment. Though no significant difference was observed between rechallenge and initial treatment regarding ORR (OR, 0.69; 95%CI, 0.39-1.20, P = .29) and DCR (OR, 0.85; 95%CI, 0.51-1.40, P = 0.52), patients receiving rechallenge had improved PFS (HR, 0.56; 95%CI, 0.43-0.73, P < .05) and OS (HR, 0.55; 95%CI, 0.43-0.72, P < .05) than those who discontinued ICI therapy permanently. Subgroup analysis revealed that for patients who stopped initial ICI treatment because of irAEs, rechallenge showed similar safety and efficacy with initial treatment, while for patients who discontinued ICI treatment due to PD, rechallenge caused a significant increase in the incidence of high-grade irAEs (OR, 4.97; 95%CI, 1.98-12.5, P < .05) and a decrease in ORR (OR, 0.48; 95%CI, 0.24-0.95, P < .05).

conclusionICI rechallenge is generally an active and feasible strategy that is associated with relative safety, similar efficacy, and improved survival outcomes. Rechallenge should be considered individually with circumspection, and randomized controlled trials are required to confirm these findings.

Indexed as

Immune Checkpoint InhibitorsNeoplasmsHumansImmune Checkpoint Inhibitorsimmune checkpoint inhibitorsimmune-related adverse eventsmeta-analysisneoplasmsrechallengesurvival analysis

Identifiers

PMID38940446
PMCPMC11546642

What OpenQuestion holds

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Registered trials

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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.