Tremelimumab 300mg/15ml solution for infusion vials

BackgroundCTLA-4 inhibitors, such as tremelimumab and ipilimumab, are increasingly used in the treatment of non-small cell lung cancer (NSCLC). This meta-analysis aims to evaluate the incidence of pneumonitis associated with these inhibitors and explore potential differences between individual agents.MethodsA systematic search across three online databases identified 911 records. After screening for duplicates and irrelevant articles, nine studies with a total of 4,164 patients were included. Risk of bias was assessed using the Cochrane "Risk of Bias" tool. Pneumonitis incidence was analyzed using a random-effects model.ResultsThe overall incidence of any-grade pneumonitis was 4.0% [95% CI (2.2%, 5.8%)]. High-grade pneumonitis occurred in 1.6% [95% CI (0.5%, 2.6%)]. Subgroup analysis revealed that tremelimumab was associated with a higher incidence of both any-grade (8.0% vs. 2.0%) and high-grade (3.0% vs. 1.0%) pneumonitis compared to ipilimumab. In a comparison with a control group, patients receiving CTLA-4 inhibitors had a significantly higher incidence of any-grade pneumonitis [OR = 3.00, 95% CI (1.60, 5.64), p p = 0.14].ConclusionThis meta-analysis indicates that CTLA-4 inhibitors are associated with a higher incidence of pneumonitis in NSCLC patients, particularly with tremelimumab. These findings underline the importance of close monitoring for pneumonitis in patients receiving CTLA-4 inhibitors, especially tremelimumab, and suggest the need for further research into prevention and management strategies.

Abstract licence: CC BY

This study aims to evaluate the efficacy and toxicity of stereotactic body radiotherapy (SBRT) in advanced pancreatic cancer (APC) patients, comparing SBRT alone to SBRT combined with immunotherapy. A systematic review was conducted following the PRISMA guidelines. Electronic databases, including Google Scholar, Medline, Embase, Cochrane, and PubMed, were searched up to October 23, 2024. Studies evaluating SBRT alone or in combination with immunotherapy for APC were included. Key outcomes assessed were overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and grade 3/4 treatment-related adverse events (TRAEs). Data were analyzed and presented as percentages. The study is registered with PROSPERO under the registration number CRD420250655873. The 1-year OS rate was 44% for SBRT alone, compared to 8% for nivolumab + ipilimumab + SBRT, 80% for durvalumab + SBRT, and 2% for durvalumab + tremelimumab + SBRT. The 1-year PFS rate was 46% for SBRT alone, versus 43%, 4%, and 3% for the respective combinations. Grade 3/4 TRAEs were lower for SBRT alone (21.5%) compared to combination therapies: 79.1% for nivolumab + ipilimumab + SBRT, 73.2% for nivolumab + SBRT, 33.3% for durvalumab + SBRT, and 61.1% for durvalumab + tremelimumab + SBRT. SBRT is an effective treatment option for APC, with a 1-year OS rate of 44% and relatively low TRAEs. The combination of durvalumab + SBRT demonstrated a promising 1-year OS rate of 80%, highlighting its potential for further investigation.

Abstract licence: CC BY-NC-ND