Immune-Related Adverse Events with PD-1 Versus PD-L1 Inhibitors: A Meta-Analysis of 8730 Patients from Clinical Trials

<b>Background:</b> Trial-level meta-analysis to investigate differences in immune-related adverse event (irAE) profiles between anti-PD-1/PD-L1 antibodies. <b>Materials &amp; methods:</b> Data analyzed from 8730 patients treated with anti-PD-1/PD-L1 monotherapy. Incidence and odds ratios (ORs) were calculated for irAEs overall, selected individual irAEs for individual agents and pooled estimates for anti-PD-1 or anti-PD-L1 antibodies. <b>Results:</b> For anti-PD-L1 versus anti-PD-1 antibodies, we observed a lower risk of any-grade rash, elevated alanine aminotransferase, colitis, grade ≥3 colitis, hypothyroidism and rash. For individual agents, we observed reduced risks of overall any-grade irAEs for atezolizumab versus pembrolizumab and grade ≥3 irAEs for avelumab versus pembrolizumab. <b>Conclusion:</b> irAE risk may vary between anti-PD-1 and anti-PD-L1 antibodies; however, findings are hypothesis-generating. A PDF version of this infographic is available as supplemental material.

<b>研究背景：</b> 本研究为试验层面的荟萃分析，旨在探究抗PD-1/PD-L1抗体之间的免疫相关不良事件(immune-related adverse event, irAE)谱差异。<b>材料与方法：</b> 本研究分析了8730例接受抗PD-1/PD-L1单药治疗的患者数据。针对总体免疫相关不良事件、各药物对应的特定单项免疫相关不良事件，以及抗PD-1或抗PD-L1抗体的合并效应量，分别计算了其发生率与比值比(odds ratios, ORs)。<b>研究结果：</b> 与抗PD-1抗体相比，抗PD-L1抗体对应的任意级别皮疹、丙氨酸氨基转移酶升高、结肠炎、≥3级结肠炎、甲状腺功能减退及皮疹的发生风险更低。针对具体药物而言，相较于帕博利珠单抗(pembrolizumab)，阿替利珠单抗(atezolizumab)的总体任意级别免疫相关不良事件发生风险更低；相较于帕博利珠单抗，阿维鲁单抗(avelumab)的≥3级免疫相关不良事件发生风险更低。<b>研究结论：</b> 抗PD-1与抗PD-L1抗体之间的免疫相关不良事件发生风险或存在差异，但本研究结果仅为假说生成提供依据。本信息图的PDF版本可作为补充材料获取。