Work

Clinical Outcomes of Immunosuppressant Drugs in Patients Treated with Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis

Year: 2026

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: OBJECTIVES: The aim of this study was to systematically evaluate the impact of immunosuppressant drugs (ISDs) use on clinical outcomes in patients with cancer treated with immune checkpoint inhibitors (ICIs). METHODS: A systematic review and meta-analysis was conducted. Eligible studies reporting overall survival (OS) and/or progression-free survival (PFS), among adult cancer patients receiving ICIs stratified by the use of ISDs. RESULTS: A total of 33 studies with 34,063 patients met the inclusion criteria. Pooled analyses showed significantly worse outcomes among patients receiving ISDs during ICI therapy, with poorer OS (HR = 1.31; 95% CI: 1.10-1.56; p = 0.003) and PFS (HR = 1.39; 95% CI: 1.10-1.76; p = 0.006) compared with those who did not receive ISDs with high heterogeneity of (I2 ∼ 80-85%). In subgroup analysis, patients with non-small-cell lung cancer exhibited significantly reduced OS associated with the use of ISDs. CONCLUSIONS: The results suggest an association between ISDs use and reduced OS and PFS in patients with cancer receiving ICI treatment. These findings highlight the need for precision-based immune-related adverse events (irAEs) management strategies that balance toxicity control with preservation of therapeutic benefit.

Source: Medical Principles and Practice

DOI: 10.1159/000553094