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Evidence from a meta-analysis: is nivolumab neurotoxic in cancer patients?

Authors Kong X, Kong Y

Received 22 August 2016

Accepted for publication 1 November 2016

Published 1 March 2017 Volume 2017:10 Pages 1335—1344


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr XuYu Yang

Xiangyi Kong,1,2 Yanguo Kong1

1Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Dongcheng District, Beijing, People’s Republic of China; 2Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Harvard University, Boston, MA, USA

The aim of this study was to summarize the findings of previous studies focusing on whether the risks of certain neurotoxicities are correlated to the programmed death 1 (PD-1) inhibitor nivolumab versus other chemotherapy or immunotherapy drugs. Six eligible studies, including 3,023 patients, were considered in the meta-analysis. The risk ratios (RRs) of fatigue, headache, dysgeusia, vertigo, paresthesia, anxiety or malaise and peripheral neuropathy were 0.908 (95% confidence interval [95% CI]: 0.724, 1.138; P=0.402), 0.841 (95% CI: 0.606, 1.168; P=0.302), 0.423 (95% CI: 0.132, 1.357; P=0.148), 0.762 (95% CI: 0.475, 1.223; P=0.261), 0.411 (95% CI: 0.232, 0.730; P=0.002), 1.049 (95% CI: 0.094, 11.752; P=0.969) and 0.192 (95% CI: 0.039, 0.935; P=0.041), respectively. Our analysis supported that the PD-1 inhibitor nivolumab did not cause increased or decreased risks of fatigue, headache, dysgeusia, vertigo and anxiety or malaise and was associated with decreased risks of paresthesia and peripheral neuropathy as compared with controls. These outcomes indicated that although clinicians should be attentive of the side effects of nivolumab, in terms of nervous system side effects, nivolumab is generally safe.

Keywords: PD-1 inhibitor, nivolumab, neurotoxicity, cancer

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