Pneumonitis with combined immune checkpoint inhibitors and chemoradiotherapy in locally advanced non-small-cell lung cancer: a systematic review and meta-analysis.
Linlin YangButuo LiYiyue XuBing ZouBingjie FanChunni WangLinlin WangPublished in: Future oncology (London, England) (2023)
Aims: This study systematically evaluated cases of pneumonitis following combined immune checkpoint inhibitors (ICI) and chemoradiotherapy (CRT) for locally advanced non-small-cell lung cancer (LA-NSCLC). Methods: Studies from Embase, PubMed and the Cochrane Library on patients with LA-NSCLC who received CRT and ICIs were reviewed. The primary outcomes were rates of all-grade, grade 3-5 and grade 5 pneumonitis. Results: Overall, 35 studies involving 5000 patients were enrolled. The pooled rates of all-grade, grade 3-5 and grade 5 pneumonitis were 33.0% (95% CI: 23.5-42.6), 6.1% (95% CI: 4.7-7.4) and 0.8% (95% CI: 0.3-1.2), respectively, with 7.6% of patients discontinuing ICIs because of pneumonitis. Conclusion: The incidence rates of pneumonitis following combined CRT and ICIs for LA-NSCLC were acceptable. However, the pulmonary toxicity of concurrent CRT and nivolumab plus ipilimumab should be noted.
Keyphrases
- advanced non small cell lung cancer
- epidermal growth factor receptor
- end stage renal disease
- small cell lung cancer
- interstitial lung disease
- ejection fraction
- newly diagnosed
- peritoneal dialysis
- prognostic factors
- pulmonary hypertension
- locally advanced
- skeletal muscle
- clinical trial
- risk factors
- radiation therapy
- cardiac resynchronization therapy
- rheumatoid arthritis
- atrial fibrillation
- patient reported
- insulin resistance
- tyrosine kinase
- study protocol