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Background <p>Advanced non-squamous non-small cell lung cancer has a poor prognosis, and immune checkpoint inhibitors (ICIs) plus platinum-based combination chemotherapy is the first-line treatment. Atezolizumab, an ICI, has three regimens: atezolizumab + carboplatin (CBDCA) + paclitaxel + bevacizumab [ABCP], atezolizumab + CBDCA + nab-paclitaxel (nab-PTX) [A + CnP], and atezolizumab + CBDCA + pemetrexed [A + CbP]. However, clinical trials directly comparing these regimens have not been reported, and the differences in adverse events have not been fully clarified.</p> Methods <p>We calculated the reporting odds ratio (ROR), a measure of adverse drug reaction (ADR) signals, using the FDA Adverse Event Reporting System (FAERS) to compare the major ADRs of ABCP, A + CnP, and A + CbP regimens.</p> Results <p>The ROR (95% confidence interval [CI]) for rash and hypersensitivity-related adverse events was 2.06 (1.81–2.34) for ABCP, 0.81 (0.42–1.56) for A + CnP, and 0.57 (0.37–0.87) for A + CbP; the signal was only detected for the ABCP regimen. In acute kidney injury (AKI), it was ABCP: 1.24 (0.89–1.73), A + CnP: 1.16 (0.37–3.60), and A + CbP: 1.76 (1.06–2.93), and signal was detected only for the A + CbP regimen. Contrarily, signals were detected for colitis, drug-induced liver injury, and pneumonitis for all regimens.</p> Conclusions <p>Rash and hypersensitivity-related adverse events and AKI were more frequently reported with the ABCP and A + CbP regimens, respectively. These observations may help generate hypotheses regarding regimen-specific adverse event profiles and support future studies toward individualized chemotherapy.</p>

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Disproportionality analysis of adverse events in advanced lung cancer treated with atezolizumab plus platinum-based combination chemotherapy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月6日

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  • Katsuyuki Hazama,
  • Toru Imai,
  • Naohiro Tochikura,
  • Shinsaku Washinosu,
  • Susumu Ootsuka,
  • Kazuhiko Hanada

摘要

Background

Advanced non-squamous non-small cell lung cancer has a poor prognosis, and immune checkpoint inhibitors (ICIs) plus platinum-based combination chemotherapy is the first-line treatment. Atezolizumab, an ICI, has three regimens: atezolizumab + carboplatin (CBDCA) + paclitaxel + bevacizumab [ABCP], atezolizumab + CBDCA + nab-paclitaxel (nab-PTX) [A + CnP], and atezolizumab + CBDCA + pemetrexed [A + CbP]. However, clinical trials directly comparing these regimens have not been reported, and the differences in adverse events have not been fully clarified.

Methods

We calculated the reporting odds ratio (ROR), a measure of adverse drug reaction (ADR) signals, using the FDA Adverse Event Reporting System (FAERS) to compare the major ADRs of ABCP, A + CnP, and A + CbP regimens.

Results

The ROR (95% confidence interval [CI]) for rash and hypersensitivity-related adverse events was 2.06 (1.81–2.34) for ABCP, 0.81 (0.42–1.56) for A + CnP, and 0.57 (0.37–0.87) for A + CbP; the signal was only detected for the ABCP regimen. In acute kidney injury (AKI), it was ABCP: 1.24 (0.89–1.73), A + CnP: 1.16 (0.37–3.60), and A + CbP: 1.76 (1.06–2.93), and signal was detected only for the A + CbP regimen. Contrarily, signals were detected for colitis, drug-induced liver injury, and pneumonitis for all regimens.

Conclusions

Rash and hypersensitivity-related adverse events and AKI were more frequently reported with the ABCP and A + CbP regimens, respectively. These observations may help generate hypotheses regarding regimen-specific adverse event profiles and support future studies toward individualized chemotherapy.