单位：[1]Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China Department of Pathology, Research Institute of McGill University Health Center, Montreal, Quebec, Canada临床科室肿瘤中心肿瘤内科医技科室病理科病理科首都医科大学附属北京友谊医院[2]Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China[3]Department of Biomedical Engineering of Anatomy, Histology and Embryology, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences,School of Basic Medicine Peking Union Medical College[4]Department of Thoracic Surgery, Jinan Center Hospital Affiliated to Shandong University, Shandong University, Jinan, 250014, China[5]Department of Pathology, Research Institute of McGill University Health Center, Montreal, Quebec, Canada[6]Liaocheng City Hospital, Shandong Province, PR China
Background: We performed a meta-analysis to evaluate the risk of immune-related colitis associated with PD1/PD-L1 inhibitors as compared to chemotherapy in solid tumor patients. Methods: Eligible studies were identified through a comprehensive search of multiple databases and included solid tumor patients in randomized controlled trials (RCTs) with PD-1/PD-L1 inhibitors. The data was analyzed by Stata version 12.0 software. Results: After exclusion of ineligible studies, 11 clinical trials were considered eligible for the meta-analysis, including 5751 patients. Compared with chemotherapy, the risk ratios (RRs) of all-grade colitis were significant for the PD-1 inhibitor subgroup (RR 2.69, 95% confidence interval (CI): 1.15-6.29, p=0.023), and for pembrolizumab subgroup (RR 3.17, 95% CI: 1.08-9.37, p=0.037), but not for nivolumab treatment and PD-L1 inhibitor (atezolizumab) treatment (RR 2.05, 95% CI: 0.52-8.13, p=0.305; RR 4.75,95% CI: 0.56-40.50, p=0.154, respectively). The RR of all-grade colitis was significant for PD-1/PD-L1 inhibitor in NSCLC (RR 4.34, 95% CI: 1.37-13.82, p=0.013), and not significant in melanoma (RR 2.11, 95% CI: 0.54-8.34, p=0.285). Moreover, the RRs of all-grade diarrhea were significant for the PD-1 inhibitor subgroup (RR 0.61, 95% CI: 0.44-0.83, p=0.002), for the nivolumab subgroup (RR 0.54, 95% CI: 0.34-0.87, p=0.012), and for atezolizumab subgroup (RR 0.48, 95% CI: 0.25-0.89, p=0.021). The RR of high-grade diarrhea was significant for atezolizumab subgroup (RR 0.34, 95% CI: 0.12-0.94, p=0.037). Conclusions: Our meta-analysis demonstrates that compared with chemotherapy, pembrolizumab may result in a higher risk of all-grade immune-mediated colitis. PD-1/PD-L1 inhibitor treatment in NSCLC patients, but not in melanoma patients, increases the risk of all-grade colitis incidence.
基金：
Foundation of clinical research of Capital Medical University [15JL33]; Foundation of Beijing friendship hospital [yyqdkt 2014-12]
第一作者单位：[1]Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China Department of Pathology, Research Institute of McGill University Health Center, Montreal, Quebec, Canada
通讯作者：
通讯机构：[5]Department of Pathology, Research Institute of McGill University Health Center, Montreal, Quebec, Canada[6]Liaocheng City Hospital, Shandong Province, PR China
推荐引用方式(GB/T 7714)：
Su Qiang,Zhang Xiaochen,Shen Xinhua,et al.Risk of immune-related colitis with PD-1/PD-L1 inhibitors vs chemotherapy in solid tumors: systems assessment[J].JOURNAL of CANCER.2018,9(9):1614-1622.doi:10.7150/jca.24200.
APA：
Su, Qiang,Zhang, Xiaochen,Shen, Xinhua,Hou, Yanli,Sun, Zhigang&Gao, Zu Hua.(2018).Risk of immune-related colitis with PD-1/PD-L1 inhibitors vs chemotherapy in solid tumors: systems assessment.JOURNAL of CANCER,9,(9)
MLA：
Su, Qiang,et al."Risk of immune-related colitis with PD-1/PD-L1 inhibitors vs chemotherapy in solid tumors: systems assessment".JOURNAL of CANCER 9..9(2018):1614-1622
