{"id":26642,"date":"2020-12-09T08:00:00","date_gmt":"2020-12-09T08:00:00","guid":{"rendered":"http:\/\/1cefc20ddc1b422ba0d1659321c7e3c6"},"modified":"2024-11-03T15:15:52","modified_gmt":"2024-11-03T15:15:52","slug":"haematologic-toxicity-not-increased-with-immunochemotherapy-combinations-over-chemotherapy-treatment-for-solid-tumours","status":"publish","type":"post","link":"https:\/\/ogkologos.com\/en\/haematologic-toxicity-not-increased-with-immunochemotherapy-combinations-over-chemotherapy-treatment-for-solid-tumours\/","title":{"rendered":"Haematologic Toxicity Not Increased with Immunochemotherapy Combinations Over Chemotherapy Treatment for Solid Tumours"},"content":{"rendered":"

No significant increase in all-grade haematologic toxicity was found with the addition of an anti-PD1\/PD-L1-based or anti-CTLA4-based therapy to chemotherapy as compared to chemotherapy alone in patients with solid tumours, according to findings presented at the ESMO Immuno-Oncology Virtual Congress 2020<\/a>, held from 9 to 12 December 2020.<\/p>\n

Lead poster author Daniel Eiger of the Clinical Trials Support Unit, Institut Jules Bordet in Brussels, Belgium noted that combination of immunotherapy and chemotherapy has become a standard treatment option in several settings, but whether there is an additive toxicity effect had not been sufficiently investigated. This question prompted an evaluation of treatment-induced myelotoxicity and immune-mediated cytopenias due to the addition of an immune checkpoint inhibitor (ICI) to chemotherapy.<\/p>\n

This meta-analysis initiated a systematic review of the MEDLINE and Cochrane databases as well as conference proceedings, according to a manual selection of studies presented at major congresses, that occurred up to 5 June 2020. The review was restricted to English language publications and included randomised clinical studies comparing immunotherapy\/chemotherapy combinations to chemotherapy in patients with solid tumours.<\/p>\n

The main endpoints of the analysis included all-grade anaemia, neutropenia, febrile neutropenia (FN), and thrombocytopenia. The same cytopenias grouped by grades 1 to 2, 3 to 4, and 5 served as the other endpoints. Subgroup analyses were performed according to the class of ICI and a sensitivity analysis that excluded trials with a different number of cycles of chemotherapy between arms was done. Random effects models were used in pooled odds ratio (pOR) and confidence interval (CI) calculations.<\/p>\n

The incidence of all-grade cytopenia was not increased with the addition of an immunotherapy to chemotherapy<\/h4>\n

The investigators identified 19 publications; of these, 14 assessed anti-PD1\/PD-L1-based immunochemotherapy and 5 evaluated an anti-CTLA4-based combination, with a total of 5254 patients in the immunotherapy\/chemotherapy arm and 4316 in the chemotherapy arm.<\/p>\n

Comparison of the immunotherapy\/chemotherapy and chemotherapy arms provided pooled incidences of all-grade cytopenias. The specific incidences were: Anaemia 42% versus 38%, neutropenia 33% versus 30%, FN 7% versus 5%, and thrombocytopenia 20% versus 17%, respectively.<\/p>\n

No significant increase in the odds of all-grade adverse events (AEs) was found for immunotherapy\/chemotherapy compared to chemotherapy in any of the cytopenias evaluated: Anaemia (pOR 1.04; 95% CI 0.90-1.21; p = 0.58), neutropenia (pOR 1.01; 95% CI 0.87-1.16; p = 0.94), FN (pOR 1.24; 95% CI 0.97-1.58; p = 0.09), and thrombocytopenia (pOR 1.14; 95% CI 1.00-1.30; p = 0.06). No significant increase in the odds of G1-2, G3-4, and G5 adverse events (AEs) were found as well.<\/p>\n

In subgroup analysis according to major class of ICI (anti-PD(L)1-based immunotherapy\/chemotherapy and anti-CTLA-4-based immunotherapy\/chemotherapy), only a small albeit statistically significant increment in the odds of all grade thrombocytopenia was found with an anti-PD1\/PD-L1-based immunotherapy\/chemotherapy compared to chemotherapy (pOR 1.18; 95% CI 1.02-1.36; p = 0.03).<\/p>\n

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Pooled incidences and pooled Odds Ratio (pOR) with 95% confidence intervals (95% CI) in the immunotherapy\/chemotherapy vs. chemotherapy alone groups and subgroups, according to major immune checkpoint inhibitor classes.<\/p>\n

\u00a9 Daniel Eiger.<\/p>\n<\/div>\n<\/figcaption><\/figure>\n<\/div>\n<\/div>\n

The sensitivity analysis provided similar results.<\/p>\n

Conclusions<\/h4>\n

The authors of the poster wrote that, apart from a small increase in the odds of all grade thrombocytopenia with anti-PD1\/PD-L1-based immunochemotherapy, the combination of an immunotherapy plus chemotherapy appears to be as safe as chemotherapy in terms of haematological toxicities.<\/p>\n

No external funding was disclosed.<\/p>\n

Reference<\/h4>\n

44P \u2013 Eiger D, Agostinetto E, Caparica R, et al.<\/em> The hematologic toxicities of chemo-immunotherapy compared to chemotherapy alone: A systematic review and meta-analysis. ESMO Immuno-Oncology Virtual Congress 2020<\/a> (9-12 December).<\/p>\n

Source<\/a><\/p>","protected":false},"excerpt":{"rendered":"

No significant increase in all-grade haematologic toxicity was found with the addition of an anti-PD1\/PD-L1-based or anti-CTLA4-based therapy to chemotherapy as compared to chemotherapy alone in patients with solid tumours, according to findings presented at the ESMO Immuno-Oncology Virtual Congress 2020, held from 9 to 12 December 2020. Lead poster author Daniel Eiger of the […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"footnotes":""},"categories":[5137],"tags":[],"class_list":["post-26642","post","type-post","status-publish","format-standard","hentry","category-world-news"],"_links":{"self":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/26642","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/comments?post=26642"}],"version-history":[{"count":1,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/26642\/revisions"}],"predecessor-version":[{"id":45996,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/26642\/revisions\/45996"}],"wp:attachment":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/media?parent=26642"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/categories?post=26642"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/tags?post=26642"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}