Opdivo immunotherapy is not associated with haematological toxicity in cancer patients

A meta-analysis reports a lower incidence of haematological toxicity than similar drugs.

Context

• The immune checkpoint inhibitor nivolumab is approved in the United States and Europe for at least 10 types of cancer, including melanoma, non-small cell lung cancer, renal cell carcinoma, and gastric cancers.
• Nivolumab works by inhibiting the immunosuppressive molecule programmed cell death protein 1.
• No comprehensive review or meta-analysis examined its potential haematological toxicity.

Conclusions

• Nivolumab is associated with lower haematological toxicity than similar drugs in cancer patients.

Why it matters

• This meta-analysis, the first of its kind, offers reassurance to doctors and patients.
• Opdivo may be excluded as a source of haematological toxicity in cancer patients treated with multiple drugs.

Study design

• Meta-analysis of five randomized phase 3 clinical trials involving 2,399 patients with various cancers, identified after a search of the PubMed, Embase, Web of Science and China National Knowledge Infrastructure databases.
• Primary outcomes: anemia, neutropenia and leukopenia.
• Funding: none.

Main results

• Nivolumab was associated with a lower risk of haematological toxicity than similar drugs (e.g.dacarbazine, docetaxel and everolimus).
  • Anaemia: relative risk (RR)=0.343; 95% CI, 0.177–0.663, a 66% risk reduction.
  • Neutropenia: RR=0.020; 95% CI, 0.008–0.053, a 98% risk reduction.
  • Leukopenia: RR=0.054; 95% CI, 0.015–0.191, a 95% risk reduction.

• Anaemia: relative risk (RR)=0.343; 95% CI, 0.177–0.663, a 66% risk reduction.
• Neutropenia: RR=0.020; 95% CI, 0.008–0.053, a 98% risk reduction.
• Leukopenia: RR=0.054; 95% CI, 0.015–0.191, a 95% risk reduction.

Limitations

• Heterogeneity between studies related to different doses and frequencies of nivolumab, different control drugs, and/or different tumor types.

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Source — https://www.univadis.it/viewarticle/limmunoterapia-con-nivolumab-non-associata-a-tossicita-ematologica-nei-pazienti-oncologici