Work

Impact of Immune-Related Adverse Events on Survival in Patients With Gastrointestinal Cancer Treated With Immune Checkpoint Inhibitors: A Meta-Analysis

Year: 2025

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: INTRODUCTION: Immune-related adverse events (irAEs) stemming from off-target immune activation have been associated with improved survival outcomes in various cancers. Nonetheless, the influence of irAEs on survival among gastrointestinal (GI) cancer patients treated with immune checkpoint inhibitors (ICIs) remains ambiguous. The aim of this meta-analysis was to clarify the relationship between irAEs and survival outcomes in this patient cohort. METHODS: We systematically searched PubMed, Embase, and Web of Science to identify relevant observational studies with longitudinal data. Studies reported on overall survival (OS) or progression-free survival (PFS) among patients with GI cancer treated with ICIs, comparing those with irAEs with those without. We calculated pooled hazard ratios (HRs) and 95% confidence intervals (CIs) using a random-effects model to account for heterogeneity. RESULTS: Our analysis included 22 retrospective cohort studies comprising 2,935 patients; 1,142 (38.9%) experienced irAEs. The pooled analyses indicated a significant association between the occurrence of irAEs and improved OS (HR: 0.45, 95% CI 0.36-0.57, P < 0.001, I2 = 56%) and PFS (HR: 0.44, 95% CI 0.34-0.57, P < 0.001, I2 = 65%). Subgroup analyses supported the consistency of these findings across tumor location, study quality scores, follow-up duration, and analytical models, with no significant differences noted ( P for subgroup differences all >0.05). DISCUSSION: The presence of irAEs in patients with GI cancer receiving ICIs correlates with significantly better OS and PFS. This suggests that irAEs may be a potential biomarker for predicting treatment response.

Source: Clinical and Translational Gastroenterology

DOI: 10.14309/ctg.0000000000000875

Authors: Wenxing Yan, Lijuan Qin, Yingying Han, Xueli Jia, Juan Wu

Institutions: Shanxi Medical University, Chinese Academy of Medical Sciences & Peking Union Medical College, Shanxi Provincial Cancer Hospital

Language: English

Topic: Cancer Immunotherapy and Biomarkers

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,800