Abstract
Background
Immune checkpoint inhibitors (ICIs) treatment among cancer patients has been shown to have antiviral effects by reactivating exhausted T cells. However, they could also trigger inflammatory storm. Therefore, prior exposure to ICIs may influence the risk of SARS-CoV2 infection and subsequent mortality. Recent results from studies of ICIs treatment on incidence and mortality of COVID-19 are controversial.
Materials and methods
We searched databases PubMed, Embase, ISI of Knowledge, Cochrane Central Register of Controlled Trials (CENTRAL), as well as pre-print databases (MedRxiv and BioRxiv) for retrospective and prospective studies comparing ICIs versus other antitumor treatments in cancer patients in the area of COVID-19 pandemic. The primary outcome was the incidence of COVID-19. The secondary outcomes were mortality of COVID-19.
Results
Twenty-three studies with a total of 117,735 patients were selected. Compared with other antitumor treatments, prior exposure to ICIs had not an increased risk of incidence [Odds ratio (OR), 0.84; 95% confidence interval (CI), 0.60–1.18; P = 0.32] and mortality (OR, 1.22; 95% CI, 0.91–1.62; P = 0.18) of COVID-19 infectioin. Our subgroup and meta-regression analyses indicated that prior exposure to ICIs may reduce the incidence of COVID-19 in metastatic cancer patients.
Conclusions
There was no significant difference on incidence and mortality of COVID-19 between prior exposure to ICIs with other anti-tumor treatments. ICIs may reduce infection susceptibility of COVID-19 in metastatic cancer patients.
【저자키워드】 COVID-19, Cancer, meta-analyses, Immune checkpoint inhibitors, 【초록키워드】 Treatment, Mortality, T cells, susceptibility, COVID-19 pandemic, Prospective Study, Infection, risk, database, SARS-CoV2 infection, Antiviral effect, Patient, Cancer patients, incidence, inhibitor, retrospective, cancer patient, Primary outcome, 95% CI, no significant difference, 95% confidence interval, increased risk, medRxiv, secondary outcome, bioRxiv, material, inflammatory storm, ISI, recent, Result, selected, shown, indicated, subsequent, searched, reduce, Controlled, incidence of COVID-19, meta-regression analysis, 【제목키워드】 Treatment, Meta-analysis, Mortality, systematic review, Immune checkpoint inhibitor, incidence, Affect,