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Risk of immune-related adverse events associated with ipilimumab-plus-nivolumab and nivolumab therapy in cancer patients

Authors Zhou S, Khanal S, Zhang H

Received 3 November 2018

Accepted for publication 28 December 2018

Published 31 January 2019 Volume 2019:15 Pages 211—221


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Deyun Wang

Shi Zhou,* Samrat Khanal,* Haijun Zhang

Department of Oncology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu, People’s Republic of China

*These authors contributed equally to this work

Purpose: The aim of this study was to evaluate the risk of immune-related adverse events (irAEs) among cancer patients receiving nivolumab-plus-ipilimumab therapy and nivolumab monotherapy.
Patients and methods: PubMed and Web of Science were searched for related studies from inception to June 2018. Eligible studies included randomized controlled trials comparing nivolumab-plus-ipilimumab with nivolumab alone in cancer patients reporting on all-grade (grade 1–4) and high-grade (grade 3/4) irAEs. Paired reviewers selected studies for inclusion and extracted data. The odds risk and 95% CI were calculated.
Results: A total of 2,946 patients from four studies were included in the meta-analysis. The underlying malignancies included lung cancer (two trials) and melanoma (two trials). Compared with nivolumab monotherapy, the nivolumab-plus-ipilimumab therapy was associated with a significantly higher risk of all- and high-grade irAEs such as pruritus, rash, diarrhea, colitis, alanine aminotransferase elevation, and pneumonitis.
Conclusion: The combination therapy of nivolumab and ipilimumab increased the incidence of irAEs in patients with advanced cancer.

Keywords: immune-related adverse events, immune checkpoint inhibitors, nivolumab, ipilimumab, lung cancer, melanoma

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