2024 World Conference on Lung Cancer (WCLC) - Posters-P2.11C.02 Incidence of Hematological Toxicity with Use of Immunotherapy and Chemotherapy in Advanced NSCLC: A Network Meta Analysis

P2.11C.02 Incidence of Hematological Toxicity with Use of Immunotherapy and Chemotherapy in Advanced NSCLC: A Network Meta Analysis

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This document details a network meta-analysis that investigates the incidence of hematological toxicity associated with various treatments for advanced non-small cell lung cancer (NSCLC). Conducted by Wenhai Fu, Yu Jiang, Wenjun Ye, and Wenhua Liang at the First Affiliated Hospital of Guangzhou Medical University, the study analyzed data from 38 randomized controlled trials encompassing 24,951 patients and 13 different treatment interventions.<br /><br />The primary focus was the incidence of Grade 3 hematologic toxicities, while secondary outcomes included all grades of such events. Using random-effects models, the study assessed first-line and post-line treatments alongside different chemotherapy combinations.<br /><br />Key findings revealed that immunotherapy combined with chemotherapy, especially CTLA-4Chemo, PD-1CTLA-4Chemo, and PD-1Chemo, increased risks for several Grade 3 hematological toxicities. Specifically, these combinations raised the likelihood of Grade 3 anemia, neutrophil, and platelet and white blood cell count depletion more significantly than conventional chemotherapy alone.<br /><br />The study's subgroup analysis corroborated these overall trends, highlighting a consistent pattern across various treatment regimens. Single-arm meta-analyses confirmed the heightened risk of hematologic toxicity with these combined therapeutic approaches.<br /><br />In conclusion, the report suggests that immune checkpoint inhibitors, when used with chemotherapy, elevate the risk of hematologic toxicity, possibly due to complex interactions affecting immune activity, angiogenesis, and the impact on hematopoietic cells. The authors stress the necessity for further research to explore the molecular mechanisms behind these synergistic effects and to identify predictors for increased toxicity in these combined treatments.

Asset Subtitle

Wenhai Fu

Meta Tag

Speaker Wenhai Fu

Topic Metastatic NSCLC – Immunotherapy

Keywords

network meta-analysis

hematological toxicity

NSCLC

immunotherapy

chemotherapy

CTLA-4Chemo

PD-1CTLA-4Chemo

Grade 3 toxicities

immune checkpoint inhibitors

hematopoietic cells