Incidence of fatigue associated with immune checkpoint inhibitors in patients with cancer: a meta-analysis

KISS, Igor, Matyáš KUHN, K. HRUSAK a T. BUCHLER. Incidence of fatigue associated with immune checkpoint inhibitors in patients with cancer: a meta-analysis. ESMO OPEN. AMSTERDAM: ELSEVIER, 2022, roč. 7, č. 3, s. 1-7. ISSN 2059-7029. Dostupné z: https://dx.doi.org/10.1016/j.esmoop.2022.100474.

Základní údaje

Originální název

Incidence of fatigue associated with immune checkpoint inhibitors in patients with cancer: a meta-analysis

Autoři

KISS, Igor (203 Česká republika, domácí), Matyáš KUHN (203 Česká republika, domácí), K. HRUSAK (203 Česká republika) a T. BUCHLER (203 Česká republika)

Vydání

ESMO OPEN, AMSTERDAM, ELSEVIER, 2022, 2059-7029

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Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30204 Oncology

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 7.300

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1016/j.esmoop.2022.100474

UT WoS

001044008800008

Klíčová slova anglicky

checkpoint inhibitors; fatigue; meta-analysis; chemotherapy; immunotherapy; targeted therapy

Štítky

14110811, 14119612, rivok

Příznaky

Mezinárodní význam, Recenzováno

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Anotace

V originále

Background: Fatigue is one of the most common adverse effects associated with cancer immunotherapy using checkpoint inhibitors (CPIs). Because treatment-related fatigue also frequently occurs in patients treated with non-immunological therapies, our study aimed to compare the incidence of fatigue in CPI-treated patients with that associated with non-immune therapies in randomised trials. Methods: PubMed and ClinicalTrials.gov were searched for phase III studies using a CPI alone or in combination with chemotherapy or non-immunologic targeted therapy in the experimental arm and control arm using inactive therapies such as placebo or observation, chemotherapy, or non-immunologic targeted therapy. Adverse events listed in the full texts as well as those available from clinicaltrials.gov were reviewed for all identified studies. Results: A total of 60 studies involving 41 435 patients were included in the analysis. All-grade fatigue was reported in 30.4% of patients [95% confidence interval (CI) 29.9% to 31.0%] in the immunotherapy arms of the analysed studies. Using anti-programmed cell death protein 1 agents as reference, the odds ratio (OR) for fatigue was significantly higher both for anti-cytotoxic T lymphocyte-associated antigen 4 agents (OR 1.46, 95% CI 1.04-2.04) and the combination of anti-cytotoxic T lymphocyte-associated antigen 4 and anti-programmed cell death protein agents (OR 1.43, 95% CI 1.12-1.83). Fatigue was significantly less likely to occur in patients treated with CPI compared with patients receiving chemotherapy (OR 0.79, 95% CI 0.73-0.85), but significantly was more common in patients receiving the combination of CPI/chemotherapy compared with patients receiving chemotherapy alone (OR 1.12, 95% CI 1.03-1.22). Conclusions: Although immunotherapy using CPIs was associated with treatment-related fatigue, the occurrence of allgrade fatigue was significantly higher in patients treated with chemotherapy compared with patients receiving CPIs. The risk of fatigue was higher for CPI/chemotherapy combinations than for chemotherapy alone. These results suggest that although the effects of CPIs and chemotherapy are additive, chemotherapy was the dominant cause of treatment-related fatigue in the analysed trials.