Adverse events in lymphoma patients treated with phosphoinositide 3 kinase Inhibitor in clinical trials: a meta-analysis

Background Malignant lymphomas are one of the most common cancers worldwide and with high biologic heterogeneity, while the phosphoinositide 3 kinase (PI3K)/mTOR pathway is crucial in maintaining cell growth and survival both in physiological and in pathological conditions (i.e., lymphoma). PI3K inh...

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Veröffentlicht in:Annals of hematology 2022-08, Vol.101 (8), p.1741-1753
Hauptverfasser: Shan, Weihang, Wu, Guixiang, Huang, Yueting, Zeng, Hanyan, Xia, Weilin, Lin, Zhijuan, Xu, Bing
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container_end_page 1753
container_issue 8
container_start_page 1741
container_title Annals of hematology
container_volume 101
creator Shan, Weihang
Wu, Guixiang
Huang, Yueting
Zeng, Hanyan
Xia, Weilin
Lin, Zhijuan
Xu, Bing
description Background Malignant lymphomas are one of the most common cancers worldwide and with high biologic heterogeneity, while the phosphoinositide 3 kinase (PI3K)/mTOR pathway is crucial in maintaining cell growth and survival both in physiological and in pathological conditions (i.e., lymphoma). PI3K inhibitors have been proven to be effective in several subtypes of lymphomas. However, the high incidence of treatment-related adverse events as well as the special safety profile in PI3K inhibitors draws great attention. Thus, this meta-analysis was conducted to compare adverse events in PI3K inhibitors to conventional regimens in lymphoma patients. Methods Articles were retrieved from PubMed, Cochrane, and Embase to identify randomized controlled trials and phase III clinical trials that used PI3K inhibitors comparing with non-PI3K inhibitors in lymphoma patients. To achieve the appropriate results, we calculated the risk ratio and 95% confidence intervals. Results Four trials with 1399 patients that met our criteria were included. The PI3K inhibitors group significantly increased the risk of all-grade adverse events (AEs) (RR 0.95, 95% CI: 0.92–0.98) and high-grade AEs (RR 0.63, 95% CI: 0.57–0.70), compared with the non-PI3K inhibitors group. Besides, the incidence of neutropenia (RR 0.81, 95% CI: 0.74–0.90), pneumonia (RR 0.62, 95% CI: 0.46–0.83), and diarrhea (RR 0.40, 95% CI: 0.32–0.49) were significantly high in the PI3Ki group, while the incidence of anemia (RR 0.78, 95% CI: 0.50–1.20) and thrombocytopenia (RR 0.85, 95% CI: 0.51–1.42) had no statistic significant. Conclusion PI3K inhibitors increased the risk of certain AEs in lymphoma patients.
doi_str_mv 10.1007/s00277-022-04876-x
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PI3K inhibitors have been proven to be effective in several subtypes of lymphomas. However, the high incidence of treatment-related adverse events as well as the special safety profile in PI3K inhibitors draws great attention. Thus, this meta-analysis was conducted to compare adverse events in PI3K inhibitors to conventional regimens in lymphoma patients. Methods Articles were retrieved from PubMed, Cochrane, and Embase to identify randomized controlled trials and phase III clinical trials that used PI3K inhibitors comparing with non-PI3K inhibitors in lymphoma patients. To achieve the appropriate results, we calculated the risk ratio and 95% confidence intervals. Results Four trials with 1399 patients that met our criteria were included. The PI3K inhibitors group significantly increased the risk of all-grade adverse events (AEs) (RR 0.95, 95% CI: 0.92–0.98) and high-grade AEs (RR 0.63, 95% CI: 0.57–0.70), compared with the non-PI3K inhibitors group. Besides, the incidence of neutropenia (RR 0.81, 95% CI: 0.74–0.90), pneumonia (RR 0.62, 95% CI: 0.46–0.83), and diarrhea (RR 0.40, 95% CI: 0.32–0.49) were significantly high in the PI3Ki group, while the incidence of anemia (RR 0.78, 95% CI: 0.50–1.20) and thrombocytopenia (RR 0.85, 95% CI: 0.51–1.42) had no statistic significant. Conclusion PI3K inhibitors increased the risk of certain AEs in lymphoma patients.</description><identifier>ISSN: 0939-5555</identifier><identifier>EISSN: 1432-0584</identifier><identifier>DOI: 10.1007/s00277-022-04876-x</identifier><identifier>PMID: 35688904</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Bias ; Clinical trials ; Confidence intervals ; Growth factors ; Hematology ; Hospitals ; Lymphoma ; Medical prognosis ; Medicine ; Medicine &amp; Public Health ; Meta-analysis ; Oncology ; Original Article</subject><ispartof>Annals of hematology, 2022-08, Vol.101 (8), p.1741-1753</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2022</rights><rights>2022. 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PI3K inhibitors have been proven to be effective in several subtypes of lymphomas. However, the high incidence of treatment-related adverse events as well as the special safety profile in PI3K inhibitors draws great attention. Thus, this meta-analysis was conducted to compare adverse events in PI3K inhibitors to conventional regimens in lymphoma patients. Methods Articles were retrieved from PubMed, Cochrane, and Embase to identify randomized controlled trials and phase III clinical trials that used PI3K inhibitors comparing with non-PI3K inhibitors in lymphoma patients. To achieve the appropriate results, we calculated the risk ratio and 95% confidence intervals. Results Four trials with 1399 patients that met our criteria were included. The PI3K inhibitors group significantly increased the risk of all-grade adverse events (AEs) (RR 0.95, 95% CI: 0.92–0.98) and high-grade AEs (RR 0.63, 95% CI: 0.57–0.70), compared with the non-PI3K inhibitors group. Besides, the incidence of neutropenia (RR 0.81, 95% CI: 0.74–0.90), pneumonia (RR 0.62, 95% CI: 0.46–0.83), and diarrhea (RR 0.40, 95% CI: 0.32–0.49) were significantly high in the PI3Ki group, while the incidence of anemia (RR 0.78, 95% CI: 0.50–1.20) and thrombocytopenia (RR 0.85, 95% CI: 0.51–1.42) had no statistic significant. 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PI3K inhibitors have been proven to be effective in several subtypes of lymphomas. However, the high incidence of treatment-related adverse events as well as the special safety profile in PI3K inhibitors draws great attention. Thus, this meta-analysis was conducted to compare adverse events in PI3K inhibitors to conventional regimens in lymphoma patients. Methods Articles were retrieved from PubMed, Cochrane, and Embase to identify randomized controlled trials and phase III clinical trials that used PI3K inhibitors comparing with non-PI3K inhibitors in lymphoma patients. To achieve the appropriate results, we calculated the risk ratio and 95% confidence intervals. Results Four trials with 1399 patients that met our criteria were included. The PI3K inhibitors group significantly increased the risk of all-grade adverse events (AEs) (RR 0.95, 95% CI: 0.92–0.98) and high-grade AEs (RR 0.63, 95% CI: 0.57–0.70), compared with the non-PI3K inhibitors group. Besides, the incidence of neutropenia (RR 0.81, 95% CI: 0.74–0.90), pneumonia (RR 0.62, 95% CI: 0.46–0.83), and diarrhea (RR 0.40, 95% CI: 0.32–0.49) were significantly high in the PI3Ki group, while the incidence of anemia (RR 0.78, 95% CI: 0.50–1.20) and thrombocytopenia (RR 0.85, 95% CI: 0.51–1.42) had no statistic significant. Conclusion PI3K inhibitors increased the risk of certain AEs in lymphoma patients.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>35688904</pmid><doi>10.1007/s00277-022-04876-x</doi><tpages>13</tpages></addata></record>
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subjects Bias
Clinical trials
Confidence intervals
Growth factors
Hematology
Hospitals
Lymphoma
Medical prognosis
Medicine
Medicine & Public Health
Meta-analysis
Oncology
Original Article
title Adverse events in lymphoma patients treated with phosphoinositide 3 kinase Inhibitor in clinical trials: a meta-analysis
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