Immune-related adverse events with PD-1 vs PD-L1 inhibitors: a meta-analysis of 8730 patients from clinical trials


immuno-oncology, immunology, pd-l1

Recently, Future Oncology  published a trial-level meta-analysis that investigated immune-related adverse events (irAEs) reported in Phase I–IIII trials of anti-PD-1 and PD-L1 agents across tumor types. The authors analyzed data from 8730 patients treated with anti-PD-1/PD-L1 monotherapy and found that there was a lower risk of any-grade rash, elevated ALT, colitis, grade ≥ 3 colitis, hypothyroidism and rash for anti-PD-L1 compared to anti-PD-1 antibodies. It was also found that patients receiving atezolizumab vs pembrolizumab had reduced risks of overall any-grade irAEs and grade ≥ 3 irAEs for those receiving avelumab vs pembrolizumab. In conclusion, these hypothesis-generating findings suggest that safety profiles for irAEs may differ among individual anti-PD-1 and anti-PD-L1 antibodies. Future studies are needed to validate any conclusions.

Abstract

Background: Trial-level meta-analysis to investigate differences in irAE profiles between anti-PD-1/PD-L1 antibodies.

Methods: Data analyzed from 8730 patients treated with anti-PD-1/PD-L1 monotherapy. Incidence and odds ratios (ORs) were calculated for irAEs overall, selected individual irAEs for individual agents, and pooled estimates for anti-PD-1 or anti-PD-L1 antibodies.

Results: For anti-PD-L1 vs anti-PD-1 antibodies, we observed a lower risk of any-grade rash, elevated ALT, colitis, grade ≥ 3 colitis, hypothyroidism and rash. For individual agents, we observed reduced risks of overall any-grade irAEs for atezolizumab vs pembrolizumab and grade ≥ 3 irAEs for avelumab vs pembrolizumab.

Conclusions: irAE risk may vary between anti-PD-1 and anti-PD-L1 antibodies; however, findings are hypothesis-generating.

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