Safety and efficacy of atezolizumab in the treatment of cancers: a systematic review and pooled-analysis
Received 27 September 2018
Accepted for publication 9 January 2019
Published 4 February 2019 Volume 2019:13 Pages 523—538
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Manfred Ogris
Yan Tie,1,2 Hui Yang,1 Rui Zhao,3 Heng Zheng,4 Daoke Yang,5 Jingyi Zhao,5 Ming Liu1,2
1Cancer Center, West China Hospital, Sichuan University, Chengdu, China; 2State Key Laboratory of Biotherapy and Collaborative Innovation Center of Biotherapy, West China Hospital, Sichuan University, Chengdu, China; 3Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China; 4Department of Gynecology, West China Second Hospital, Sichuan University, Chengdu, China; 5Department of Medical Oncology, First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
Purpose: Immune checkpoint inhibitors have developed rapidly and have demonstrated antitumor activity in various cancers. To evaluate the safety and efficacy of atezolizumab in treating cancers, we conducted this meta-analysis.
Methods: Embase, PubMed, MEDLINE, the Central Register of Controlled Trials of the Cochrane Library, and the American Society of Clinical Oncology database were searched for relevant studies. The primary outcomes were any grade adverse events (AEs) and grade ≥3 AEs. The secondary outcomes were overall objective response rate, pooled 6-month progression-free survival (PFS) rate, 1-year overall survival (OS) rate, median PFS, and median OS.
Results: Our meta-analysis was based on 14 clinical trials with 3,266 patients. The total risk of any grade AEs reached 69%, while grade ≥3 AEs happened in only 13% of participants. The overall atezolizumab-related death rate was 0.17%. Major common AEs involved fatigue (24.5%), decreased appetite (13.2%), nausea (12.3%), diarrhea (10.8%), pyrexia (10.7%), pruritus (9.6%), cough (9.5%), edema peripheral (8.6%), and rash (8.4%). The most common severe AEs were fatigue (2.2%), anemia (1.9%), and dyspnea (1.9%). Meanwhile, we found that 6% patients reached complete response and 16% partial response. The pooled 6-month PFS rate and 1-year OS rate were 0.36 (95% CI: 0.31–0.41) and 0.55 (95% CI: 0.49–0.61), respectively. The median PFS varied from 1.5 to 6.1 months, and the median OS ranged from 5.9 to 28.9 months.
Conclusion: Atezolizumab has a considerable potential in treating cancers with an acceptable risk profile.
Keywords: atezolizumab, safety, efficacy, cancer, meta-analysis
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