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Adverse events of different PD-1 inhibitors in lung cancer patients: a real-world study
Xiaowei Zheng1, Gang Tao2, Song Sun3
1Department of Pharmacy, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China.
Background:
Programmed death-1 (PD-1) inhibitors have been approved and are currently widely used to treat lung cancer patients. However, comparative data on the adverse events (AEs) associated with different PD-1 inhibitors are very limited.
Methods:
Patients with histologically confirmed lung cancer who had been treated with at least 1 dose of PD-1 inhibitors between January 2017 and December 2019 at a tertiary cancer hospital were included in the study. Data on treatment-related AEs (tr-AEs) were collected from their electronic medical records.
Results:
A total of 227 lung cancer patients treated with nivolumab (n=83), pembrolizumab (n=65), camrelizumab (n=27), sintilimab (n=31), and toripalimab (n=21) were included. In relation to nivolumab, pembrolizumab, camrelizumab, sintilimab, and toripalimab, the incidence rates of all-grade tr-AEs were 37.34%, 24.62%, 62.96%, 29.03% and 9.52%, respectively (P=0.01), and the incidence rates of grade 3-4 tr-AEs were 2.41%, 3.08%, 22.22%, 3.23% and 0%, respectively (P=0.05). The most common all-grade tr-AEs were capillary hemangioma (22.22%) and abnormal liver function (22.22%) for camrelizumab, pneumonitis for nivolumab (12.05%), pembrolizumab (6.15%) and nausea/vomiting (12.9%) for sintilimab, and pneumonitis (4.76%), rash/pruritus (4.76%) and shingles (4.76%) for toripalimab. Sex, age, PD-1 inhibitors, histology type and PD-1 cycles were significantly associated with tr-AEs.
Conclusions:
There were significant differences in the incidence and most common tr-AEs among the different PD-1 inhibitors. Different monitoring priorities should be given to different PD-1 inhibitors during treatment cycles.
Insights
Adverse events (AEs) differ significantly among programmed death-1 (PD-1) inhibitors used for lung cancer. Careful monitoring is crucial, as specific AEs vary by PD-1 inhibitor type.
Area of Science:
- Oncology
- Immunotherapy
- Pharmacovigilance
Background:
- Programmed death-1 (PD-1) inhibitors are standard lung cancer treatments.
- Comparative data on adverse events (AEs) for different PD-1 inhibitors are limited.
Purpose of the Study:
- To compare treatment-related adverse events (tr-AEs) across various PD-1 inhibitors in lung cancer patients.
- To identify specific AEs associated with different PD-1 inhibitors.
Main Methods:
- Retrospective study of 227 lung cancer patients treated with PD-1 inhibitors (nivolumab, pembrolizumab, camrelizumab, sintilimab, toripalimab).
- Data on treatment-related AEs collected from electronic medical records between January 2017 and December 2019.
Main Results:
- Significant differences in all-grade (P=0.01) and grade 3-4 (P=0.05) tr-AEs incidence were observed among PD-1 inhibitors.
- Camrelizumab showed the highest incidence of all-grade tr-AEs (62.96%), with capillary hemangioma and abnormal liver function as common AEs.
- Nivolumab was associated with pneumonitis (12.05%), while sintilimab had nausea/vomiting (12.9%).
Conclusions:
- Incidence and types of tr-AEs vary significantly between different PD-1 inhibitors.
- Monitoring priorities should be tailored to the specific PD-1 inhibitor used during treatment.
- Factors like sex, age, histology, and treatment cycles influence tr-AEs.
