10.1186/s12916-015-0455-8 http://scihub22266oqcxt.onion/10.1186/s12916-015-0455-8 C4559965!4559965
!26337719
free free free
Warning : file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=26337719
&cmd=llinks): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 215
BMC+Med
2015 ; 13
(?): 211
Nephropedia Template TP gab.com Text Twit Text FOAVip Twit Text # English Wikipedia
Immune related adverse events associated with anti-CTLA-4 antibodies: systematic
review and meta-analysis
#MMPMID26337719
Bertrand A
; Kostine M
; Barnetche T
; Truchetet ME
; Schaeverbeke T
BMC Med
2015[Sep]; 13
(?): 211
PMID26337719
show ga
BACKGROUND: Targeting CTLA-4 is a recent strategic approach in cancer control:
blocking CTLA-4 enhances an antitumor immunity by promoting T-cell activation and
cytotoxic T-lymphocyte proliferation. This induction of a tolerance break against
the tumor may be responsible for immune-related adverse events (irAEs). Our
objective was to assess the incidence and nature of irAEs in oncologic patients
receiving anti-CTLA-4 antibodies (ipilimumab and tremelimumab). METHODS: A
systematic search of literature up to February 2014 was performed in MEDLINE,
EMBASE, and Cochrane databases to identify relevant articles. Paired reviewers
independently selected articles for inclusion and extracted data. Pooled
incidence was calculated using R(©), package meta. RESULTS: Overall, 81 articles
were included in the study, with a total of 1265 patients from 22 clinical trials
included in the meta-analysis. Described irAEs consisted of skin lesions (rash,
pruritus, and vitiligo), colitis, and less frequently hepatitis, hypophysitis,
thyroiditis, and some rare events such as sarcoidosis, uveitis, Guillain-Barré
syndrome, immune-mediated cytopenia and polymyalgia rheumatic/Horton. The overall
incidence of all-grade irAEs was 72 % (95 % CI, 65-79 %). The overall incidence
of high-grade irAEs was 24 % (95 % CI, 18-30 %). The risk of developing irAEs was
dependent of dosage, with incidence of all-grade irAEs being evaluated to 61 %
(95 % CI, 56-66 %) for ipilimumab 3 mg/kg and 79 % (95 % CI, 69-89 %) for
ipilimumab 10 mg/kg. Death due to irAEs occurred in 0.86 % of patients. The
median time of onset of irAEs was about 10 weeks (IQR, 6-12) after the onset of
treatment, corresponding with the first three cycles but varied according to the
organ system involved. Such immune activation could also be indicative for
tumor-specific T-cell activation and irAE occurrence was associated with clinical
response to CTLA-4 blocking in 60 % of patients. CONCLUSION: The price of
potential long-term survival to metastatic tumors is an atypical immune toxicity,
reflecting the mechanism of action of anti-CTLA-4 antibodies. A better knowledge
of these irAEs and its management in a multidisciplinary approach will help to
reduce morbidity and therapy interruptions.
Please enable JavaScript to view the comments powered by Disqus. |Antibodies, Monoclonal, Humanized
[MESH] |Antibodies, Monoclonal/adverse effects
[MESH] |Antineoplastic Agents/*adverse effects
[MESH] |CTLA-4 Antigen/*immunology
[MESH] |Humans
[MESH] |Immunologic Factors/*adverse effects
[MESH] |Immunotherapy/adverse effects
[MESH] |Ipilimumab
[MESH] DeepDyve Pubget Overpricing