TY - JOUR
T1 - Concomitant use of corticosteroids and immune checkpoint inhibitors in patients with hematologic or solid neoplasms
T2 - A systematic review
AU - Garant, A.
AU - Guilbault, C.
AU - Ekmekjian, T.
AU - Greenwald, Z.
AU - Murgoi, P.
AU - Vuong, T.
PY - 2017/12
Y1 - 2017/12
N2 - Purpose Clinical trials studying immune checkpoint inhibitors exclude patients on corticosteroids, due to the hypothesis that corticosteroids may antagonize immunotherapy. We performed a systematic review of the literature looking at the clinical outcomes of cancer patients treated with immune checkpoint inhibitors and concomitant corticosteroids. Methods The following databases were searched for relevant studies: MEDLINE, Embase Classic + Embase, BIOSIS Previews, the Cochrane Database of Systematic Reviews, the CENTRAL Registry of Controlled Trials, Web of Science and Scopus. Abstracts from the meetings of the European Cancer Congress/European Society for Medical Oncology, the American Society of Clinical Oncology, the American Society of Hematology, the European Society for Radiotherapy & Oncology, the American Society for Radiation Oncology and the European Society for Radiotherapy & Oncology were manually searched. Two independent reviewers screened the references: case reports and articles with a low risk of bias were retained. Results Following a retrieval of 14603 unique references, 140 abstracts were retained for review; 27 articles are in the final analysis. Although limited, the reviewed data suggests that the concomitant administration of corticosteroids and immune checkpoint inhibitors may not necessarily lead to poorer clinical outcomes. Conclusion In our systematic review, there was no objective data on the exact types of corticosteroids and the dose threshold above which an interaction could be measured clinically. Consideration of stratified randomization and treatment sequence evaluations in prospective trials may clarify this challenging topic and perhaps improve patient access to immune checkpoint therapies.
AB - Purpose Clinical trials studying immune checkpoint inhibitors exclude patients on corticosteroids, due to the hypothesis that corticosteroids may antagonize immunotherapy. We performed a systematic review of the literature looking at the clinical outcomes of cancer patients treated with immune checkpoint inhibitors and concomitant corticosteroids. Methods The following databases were searched for relevant studies: MEDLINE, Embase Classic + Embase, BIOSIS Previews, the Cochrane Database of Systematic Reviews, the CENTRAL Registry of Controlled Trials, Web of Science and Scopus. Abstracts from the meetings of the European Cancer Congress/European Society for Medical Oncology, the American Society of Clinical Oncology, the American Society of Hematology, the European Society for Radiotherapy & Oncology, the American Society for Radiation Oncology and the European Society for Radiotherapy & Oncology were manually searched. Two independent reviewers screened the references: case reports and articles with a low risk of bias were retained. Results Following a retrieval of 14603 unique references, 140 abstracts were retained for review; 27 articles are in the final analysis. Although limited, the reviewed data suggests that the concomitant administration of corticosteroids and immune checkpoint inhibitors may not necessarily lead to poorer clinical outcomes. Conclusion In our systematic review, there was no objective data on the exact types of corticosteroids and the dose threshold above which an interaction could be measured clinically. Consideration of stratified randomization and treatment sequence evaluations in prospective trials may clarify this challenging topic and perhaps improve patient access to immune checkpoint therapies.
KW - Corticosteroids
KW - Human subject
KW - Immune checkpoint inhibitors
KW - Interaction
KW - Neoplasm
KW - Review
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UR - http://www.scopus.com/inward/citedby.url?scp=85033701373&partnerID=8YFLogxK
U2 - 10.1016/j.critrevonc.2017.10.009
DO - 10.1016/j.critrevonc.2017.10.009
M3 - Review article
C2 - 29198341
AN - SCOPUS:85033701373
SN - 1040-8428
VL - 120
SP - 86
EP - 92
JO - Critical Reviews in Oncology/Hematology
JF - Critical Reviews in Oncology/Hematology
ER -