Αρχική World News Haematologic Toxicity Not Increased with Immunochemotherapy Combinations Over Chemotherapy Treatment for Solid...

Haematologic Toxicity Not Increased with Immunochemotherapy Combinations Over Chemotherapy Treatment for Solid Tumours

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 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.

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.

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.

The incidence of all-grade cytopenia was not increased with the addition of an immunotherapy to chemotherapy

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.

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.

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.

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).


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.

© Daniel Eiger.

The sensitivity analysis provided similar results.


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.

No external funding was disclosed.


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



Συμπληρώστε το email σας για να λαμβάνετε τις σημαντικότερες ειδήσεις από το ogkologos.com

Βρείτε μας

2,449ΥποστηρικτέςΚάντε Like

Διαβαστε Επίσης

Καρκίνος και Κορωνοϊός (COVID-19) ΜΕΡΟΣ Α

Εάν είστε καρκινοπαθής, το ανοσοποιητικό σας σύστημα μπορεί να μην είναι τόσο ισχυρό όσο κανονικά, έτσι μπορεί να ανησυχείτε για τους κινδύνους που σχετίζονται...


Η Παγκόσμια Ημέρα Κατά του Καρκίνου καθιερώθηκε με πρωτοβουλία της Διεθνούς Ένωσης κατά του Καρκίνου (UICC), που εκπροσωπεί 800 οργανώσεις σε 155 χώρες του...


ΕΞΕΛΙΞΕΙΣ ΣΤΗ ΘΕΡΑΠΕΙΑ ΤΟΥ ΜΗ-ΜΙΚΡΟΚΥΤΤΑΡΙΚΟΥ ΚΑΡΚΙΝΟΥ ΤΟΥ ΠΝΕΥΜΟΝΑ (ΜΜΚΠ) Γράφει ο Δρ Παπαδούρης Σάββας, Παθόλογος-Ογκολόγος   Ο ΜΜΚΠ βρίσκεται αναλογικά στο 80% και πλέον του συνολικού...

Διατρέχουν όντως οι καρκινοπαθείς μεγαλύτερο κίνδυνο λόγω κοροναϊού;

Σε πρακτικό επίπεδο, τα δεδομένα των σχετικών μελετών υποδηλώνουν ότι η χημειοθεραπεία ή οι άλλες αντι-νεοπλασματικές θεραπείες δεν αυξάνουν σημαντικά τον κίνδυνο θνησιμότητας από...

FDA: Η ακτινοβολία των smartphones δεν προκαλεί καρκίνο

Σε μια νέα έκθεσή της, η Υπηρεσία Τροφίμων και Φαρμάκων (FDA) των ΗΠΑ αναφέρει ότι επανεξέτασε τις σχετικές επιστημονικές έρευνες που δημοσιεύθηκαν τα τελευταία...

Νέα ανακάλυψη, νέα ελπίδα για τον καρκίνο

Ένα νεοανακαλυφθέν τμήμα του ανοσοποιητικού μας συστήματος θα μπορούσε να αξιοποιηθεί για την αντιμετώπιση όλων των ειδών καρκίνου, σύμφωνα με επιστήμονες του πανεπιστημίου Cardiff...
- Advertisment -

Ροή Ειδήσεων

Overall Breast Cancer Incidence Down Since 1999, Rates Increase for Women Under 40

U.S. breast cancer death rates decreased by about 1% per year between 2013 and 2018. What were the new case rates during that same...

Impressive Responses to PD-1 Blockade in a Large Cohort of Children and Young Adults with Recurrent/Progressive Germline DNA Replication Repair-Deficient Cancers

A large, observational, registry-based study that leveraged systematically collected data gathered both retrospectively and prospectively through the International Replication Repair Deficiency Consortium reveals impressive...

2-Year-Boy Is So Excited To See Himself In Disney’s ‘Encanto’

The importance of representation in media has been a growing topic of concern, and companies have responded by adding more diversity to their characters,...

Man Walks Entire Continent To Spread Awareness About Mental Health & Suicide Prevention

Matthew Fennell is walking over 3,000 miles across Australia for an important cause and one that is near and dear to his heart. Last year,...

Boy Battling Cancer Becomes Honorary Police Officer, Sworn In To 45 Agencies

At just ten years old, Devarjaye “DJ” Daniel has already been through more than most people go through in their entire lives. DJ has been...

Paclitaxel and Carboplatin Not Inferior When Compared with Paclitaxel and Ifosfamide for the Treatment of Patients with Uterine Carcinosarcoma

With regard to overall survival (OS), paclitaxel and carboplatin was not inferior and demonstrated improved progression-free survival (PFS) when compared with paclitaxel and ifosfamide...