Evidence map›Paper›PMID 41994781›Full record

ReviewCureus2026

Incidence and Comparative Risk of Hematological Adverse Events Across Different Immune Checkpoint Inhibitors: A Network Meta-Analysis of Randomized Controlled Trials.

Jaahnavi Vajje, Nafisa Reyaz, Iman Gillani, Muhammad Muneeb Ullah, Sandipkumar S Chaudhari, Sidra Jabeen, Calvin R Wei, Adil Amin

Abstract readReview
In one paragraph

Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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

1 citing paper in PubMed.

  1. 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.

Jaahnavi VajjeInternal Medicine, Dr.Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Vijayawada, IND.
Nafisa ReyazMedicine, Jawaharlal Nehru Medical College and Hospital, Aligarh, IND.
Iman GillaniMedical Education, Sheikh Khalifa Bin Zayed Al-Nahyan University, Lahore, PAK.
Muhammad Muneeb UllahMedicine and Surgery, Rashid Latif Medical College, Lahore, PAK.
Sandipkumar S ChaudhariCardiothoracic Surgery, University of Alabama at Birmingham, Birmingham, USA.
Sidra JabeenInternal Medicine, Sancti Spiritus, CUB.
Calvin R WeiResearch and Development, Shing Huei Group, Taipei, TWN.
Adil AminCardiology, Pakistan Navy Ship Shifa, Karachi, PAK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Cancer immunotherapy with immune checkpoint inhibitors (ICIs) has transformed oncologic treatment, yet hematological adverse events (HAEs) remain incompletely characterized across different agents. We conducted a systematic review and network meta-analysis to compare the incidence and risk of hematological toxicities (all grades) among various ICIs. A comprehensive literature search was performed across PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science through January 2026. Phase II and III randomized controlled trials (RCTs) evaluating ICIs and reporting HAEs were included. Frequentist network meta-analysis was performed to estimate odds ratios and rankings using surface under the cumulative ranking curve values for anemia, neutropenia, and thrombocytopenia. Thirty-seven RCTs encompassing diverse malignancies were included in the network meta-analysis. For anemia, ipilimumab demonstrated the most favorable safety profile, followed by toripalimab and pembrolizumab, while serplulimab and nivolumab ranked lowest. Regarding neutropenia, ipilimumab again showed the best safety ranking, followed by avelumab and pembrolizumab, whereas toripalimab and serplulimab exhibited less favorable profiles. For thrombocytopenia, ipilimumab ranked highest, followed by sintilimab and nivolumab, while toripalimab showed the least favorable ranking. No significant global inconsistency was detected across networks. Publication bias was identified for neutropenia but not for anemia or thrombocytopenia. This network meta-analysis reveals substantial heterogeneity in hematological safety profiles across ICIs, with ipilimumab consistently demonstrating favorable rankings across all HAEs. These findings suggest potential differences in hematologic safety profiles across treatments. However, given the star-shaped network structure, reliance on indirect comparisons, and observed heterogeneity, the results should be interpreted cautiously. While not definitive, the analysis may still offer preliminary insights to inform treatment selection, particularly for patients with baseline hematological vulnerabilities or those receiving concurrent myelosuppressive therapies, and may help guide the development of risk-stratified monitoring strategies in clinical practice.

Indexed as

cancer immunotherapydrug safetyhematological adverse eventsimmune checkpoint inhibitorsnetwork meta-analysis

Identifiers

PMID41994781
PMCPMC13081760

What OpenQuestion holds

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LicenceCC BY
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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.