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@article{2248081,
author = {Kiss, Igor and Kuhn, Matyáš and Hrusak, Kristian and Buchler, Benjamin and Boublikova, Ludmila and Buchler, Tomas},
article_location = {Lausanne},
article_number = {August 2022},
doi = {http://dx.doi.org/10.3389/fonc.2022.946307},
keywords = {immunotherapy; cancer; checkpoint inhibitors; insomnia; systematic analysis},
language = {eng},
issn = {2234-943X},
journal = {Frontiers in Oncology},
title = {Insomnia in patients treated with checkpoint inhibitors for cancer: A meta-analysis},
url = {https://www.frontiersin.org/articles/10.3389/fonc.2022.946307/full},
volume = {12},
year = {2022}
}
TY - JOUR
ID - 2248081
AU - Kiss, Igor - Kuhn, Matyáš - Hrusak, Kristian - Buchler, Benjamin - Boublikova, Ludmila - Buchler, Tomas
PY - 2022
TI - Insomnia in patients treated with checkpoint inhibitors for cancer: A meta-analysis
JF - Frontiers in Oncology
VL - 12
IS - August 2022
SP - 1-13
EP - 1-13
PB - Frontiers Media S.A.
SN - 2234943X
KW - immunotherapy
KW - cancer
KW - checkpoint inhibitors
KW - insomnia
KW - systematic analysis
UR - https://www.frontiersin.org/articles/10.3389/fonc.2022.946307/full
N2 - Purpose: Insomnia in cancer patients is a common symptom contributing to poor quality of life and poor functioning. Sleep disturbances have been associated with inflammatory activity, and systemic cancer therapies chemotherapy, hormonal therapy, and immunotherapy may cause insomnia. We have carried out a meta-analysis to estimate the occurrence of insomnia in patients with solid cancer treated with immunotherapy using checkpoint inhibitors (CPI). Methods: PubMed and ClinicalTrials.gov were searched for phase 3 studies in solid tumours where treatment included a checkpoint inhibitor in the experimental arm. Data on the incidence of insomnia were acquired from the adverse events tables available from clinicaltrials.gov and/or from the full texts. Random effect logistic model was used to compare pooled data. Heterogeneity between studies was assessed using Cochrane Q statistics and I-2 statistics. Results: A total of 54 studies (including six three-arm studies) involving 37,352 patients were included in the analysis. Insomnia was reported in 8.3% of subjects (95% confidence interval [CI] 8.0%-8.7%) treated with immunotherapy. Insomnia was significantly more common in patients receiving immunotherapy compared to those enrolled in study arms with inactive treatment (odds ratio [OR] 1.49, 95% CI 1.13-1.96). The odds for insomnia were similar between the arms for studies comparing CPI versus chemotherapy and CPI versus non-immunologic targeted therapies (OR 1.07, 95% CI 0.94-1.22 and OR 1.40, 95% CI 0.90-2.18, respectively). The OR for insomnia was higher for cytotoxic T-lymphocyte antigen 4 (CTLA-4) receptor inhibitors compared to the inhibitors of programmed death-1 (PD-1) receptor (OR 1.36, 95% CI 1.06 - 1.74). Conclusion: Cancer immunotherapy using CPI is associated with insomnia but the odds of developing the symptom are not greater with immunotherapy than with other systemic modalities including chemotherapy and non-immunologic targeted therapies.
ER -
KISS, Igor, Matyáš KUHN, Kristian HRUSAK, Benjamin BUCHLER, Ludmila BOUBLIKOVA and Tomas BUCHLER. Insomnia in patients treated with checkpoint inhibitors for cancer: A meta-analysis. \textit{Frontiers in Oncology}. Lausanne: Frontiers Media S.A., 2022, vol.~12, August 2022, p.~1-13. ISSN~2234-943X. Available from: https://dx.doi.org/10.3389/fonc.2022.946307.
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