Immune Checkpoint Inhibitor-Induced Pancreatic Injury (ICI-PI) in Adult Cancer Patients: A Systematic Review and Meta-Analysis
Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Search Strategy and Protocol
2.2. Study Selection
2.3. Data Extraction
2.4. Methodological Quality
2.5. Data Analyses
3. Results
3.1. Patient Selection
3.2. Study Characteristics
3.3. Chronic Adverse Outcomes of ICI-PI
3.4. Clinical Management of ICI-PI
3.5. Survival Endpoints
3.6. Sensitivity Analysis and Bias Assessment
4. Discussion
Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Data Availability Statement
Conflicts of Interest
References
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Study $ | Total Patients | Patients with ICI-PI (n/%) | Male (n/%) | Median Age; Years (IQR or Range) | Median Follow-Up; Months (Range) |
---|---|---|---|---|---|
Abu-Sbeih, 2019 [11] | 2279 | 82/3.6 | 54/65.9 | 57 (14) † | NA |
Akazawa, 2014 [37] | 617 | 36/5.8 | 468/75.9 * | 70 * | NA |
Byun, 2020 [38] | 18 | 18/100 | 10/55.6 | 64 (27–78) | 22.6 (0.9–33.4) |
Eshet, 2018 [39] | 617 | 31/5 | 20/64.5 | 63 (35–80) | 14.5 (6.5–20) |
Eyada, 2021 [40] | 171 | 85/49.7 | 62/72.9 | 61 (4) † | 2.5 |
Gleeson, 2023 [41] | 1096 | 24/2.2 | 629/57.4 * | 68 (59–75) * | NA |
Grimmelmann, 2021 [42] | 68 | 68/100 | 33/48.5 | 58 (20–90) | 13 (8.1–22.8) |
Hori, 2024 [43] | 843 | 48/5.7 | 596/70.7 * | 71 (26–91) * | NA |
Jeun, 2023 [44] | 76 | 76/100 | 43/56.6 | 60 (32–83) | 45.9 (4.3–102.9) |
Matsukane, 2023 [45] | 1008 | 14/1.4 | 732/72.6 * | 68 (14–89) * | NA |
Nagao, 2024 [46] | 1069 | 19/1.8 | 15/78.9 | 67 (57–78) | 12.3 * |
Nagpal, 2020 [47] | 56 | 8/14.3 | 4/50 | 76 (61–88) | NA |
Ngamphaiboon, 2021 [48] | 414 | 11/2.7 | 287/69.3 * | 63 (17–97) * | NA |
Nizam, 2024 [49] | 16 | 1/6.3 | 11/68.7 * | 73 (47–79) * | NA |
Owen, 2021 [50] | 118 | 4/3.4 | 80/67.8 * | 64 (30–89) * | 21 * |
Pollack, 2018 [51] | 80 | 4/5 | 44/55 * | 56 (25–89) * | 14.3 * |
Ruf, 2024 [52] | 217 | 6/2.8 | 124/57.1 * | 66 (23–89) * | NA |
Satish, 2023 [53] | 12,905 | 23/0.2 | 16/69.6 | 62 (8) † | NA |
Shah, 2019 [54] | 1672 | 21/1.3 | NA | NA | NA |
Shi, 2022 [55] | 1905 | 20/1 | 1442/75.7 * | 63 (56–68) * | NA |
Shirwaikar, 2021 [56] | 11,165 | 248/2.2 | NA | NA | NA |
Townsend, 2023 [36] | 6450 | 105/1.6 | 59/56.2 | 64 (24–88) | 22.1 (1.2–100.6) |
Tsang, 2019 [57] | 538 | 10/1.9 | 9/90 | 62 (43–79) | NA |
Wei, 2024 [10] | 2829 | 10/0.4 | 8/80 | 63 (40–88) | NA |
Zhang, 2023 [58] | 2477 | 25/1 | 14/56 | 65 | NA |
Study $ | Tumor Sites (n/%) | Disease Stage (n/%) | Median Time of Onset, Days (Range) | Median Time to Resolution, Days (Range) | Patients with Elevated Lipase Levels (n/%) | |||||
---|---|---|---|---|---|---|---|---|---|---|
Skin | GI | Thoracic/ H&N | GU/Gynae | Others | Metastatic | Localized | ||||
Abu-Sbeih, 2019 [11] | 30/36.6 | 5/6.1 | 11/13.4 | 24/29.3 | 12/14.6 | 72/87.8 | 10/12.2 | NA | Steroid-55(11) † IVF-55(51) † | 41/50 |
Akazawa, 2014 [37] | NA | NA | NA | NA | NA | 36/100 | 0/0 | 105.5 | NA | NA |
Byun, 2020 [38] | 5/27.8 | 2/11.1 | 1/5.6 | 8/44.4 | 2/11.1 | 16/88.9 | 2/11.1 | 109.5 | NA | 4/22 |
Eshet, 2018 [39] | 21/67.7 | 0 | 10/32.3 | 0 | 0 | NA | NA | 270 # | NA | NA |
Eyada, 2021 [40] | 10/12.8 | 0 | 10/11.8 | 40/47 | 25/29.4 | 63/74.1 | 22/26 | NA | NA | NA |
Gleeson, 2023 [41] | 288/26.3 * | 27/2.5 * | 223/20.3 * | 185/16.9 * | 74/6.7 * | NA | NA | NA | NA | NA |
Grimmelmann, 2021 [42] | 68/100 | 0 | 0 | 0 | 0 | 68/100 | 0 | 135 | NA | 68/100 |
Hori, 2024 [43] | 89/10.6 * | 164/19.5 * | 429/50.9 * | 136/16 * | 25/3 * | 48/100 | 0 | NA | NA | 48/100 |
Jeun, 2023 [44] | 23/30.2 | 0/0 | 12/15.8 | 11/14.5 | 30/39.5 | NA | NA | 86.1 | NA | 20/26 |
Matsukane, 2023 [45] | 147/14.6 * | 178/17.7 * | 494/49 * | 166/16.5 * | 23/2 * | NA | NA | 66 | NA | NA |
Nagao, 2024 [46] | 4/21.1 | 1/5.3 | 4/21.1 | 10/52.5 | 0 | 335/31.4 * | 734/68.6 * | 92 (19–706) | NA | 19/100 |
Nagpal, 2020 [47] | 0 | 0 | 2/25 | 5/62.5 | 1/12.5 | NA | NA | 130.5 (1–434) | NA | 8/100 |
Ngamphaiboon, 2021 [48] | 33/8 * | 66/15.9 * | 235/56.8 * | 60/14.5 * | 20/5 * | 408/98.6 * | 6/1.4 * | 30 (14–254) | 84 (1–707) | NA |
Nizam, 2024 [49] | 0 | 0 | 0 | 1/100 | 0 | 1/100 | 0 | NA | NA | NA |
Owen, 2021 [50] | 4/100 | 0 | 0 | 0 | 0 | 107/90.7 * | 11/9.3 * | NA | NA | NA |
Pollack, 2018 [51] | 4/100 | 0 | 0 | 0 | 0 | 4/100 | 0 | NA | NA | 4/100 |
Ruf, 2024 [52] | 206/94.9 * | 3/1.4 * | 2/0.9 * | 6/2.8 * | 0 * | NA | NA | 63 | NA | NA |
Satish, 2023 [53] | 8/34.8 | 2/8.7 | 4/17.4 | 6/26.1 | 3/13 | NA | NA | 390 (252–578) # | NA | 15/65 |
Shah, 2019 [54] | NA | NA | NA | NA | NA | NA | NA | NA | NA | 17/81 |
Shi, 2022 [55] | 0 | 0 | 20/100 | 0 | 0 | 1488/78.1 * | 417/21.9 * | 92.5 | NA | NA |
Shirwaikar, 2021 [56] | NA | NA | NA | NA | NA | NA | NA | NA | NA | 248/100 |
Townsend, 2023 [36] | 33/31.4 | 5/4.8 | 18/17.2 | 12/11.4 | 37/35.2 | NA | NA | 84 | NA | 105/100 |
Tsang, 2019 [57] | 10/100 | 0 | 0 | 0 | 0 | 10/100 | 0 | 175 | NA | NA |
Wei, 2024 [10] | 3/30 | 1/10 | 3/30 | 3/30 | 0 | NA | NA | 295.5 | NA | 1/10 |
Zhang, 2023 [58] | 8/32 | 1/4 | 8/32 | 8/32 | 0 | NA | NA | 83.3 | NA | NA |
Number of Events (%) | 95% CI | |
---|---|---|
Chronic pancreatic complications | 215 (63.45%) | 29.03–91.56% |
Diabetes mellitus | 183 (89.45%) | 61.88–100.0% |
Insulin use | 18 (80.07%) | 24.49–100.0% |
Oral hypoglycemic use | 4 (19.93%) | 0.0–75.51% |
Exocrine pancreatic insufficiency | 32 (10.55%) | 0.0–38.12% |
Pancrelipase use | 25 (50.42%) | 0.0–100.0% |
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Lee, C.L.; Riya, I.J.; Piya, I.J.; Muniz, T.P.; Butler, M.O.; Saibil, S.D. Immune Checkpoint Inhibitor-Induced Pancreatic Injury (ICI-PI) in Adult Cancer Patients: A Systematic Review and Meta-Analysis. Cancers 2025, 17, 1080. https://doi.org/10.3390/cancers17071080
Lee CL, Riya IJ, Piya IJ, Muniz TP, Butler MO, Saibil SD. Immune Checkpoint Inhibitor-Induced Pancreatic Injury (ICI-PI) in Adult Cancer Patients: A Systematic Review and Meta-Analysis. Cancers. 2025; 17(7):1080. https://doi.org/10.3390/cancers17071080
Chicago/Turabian StyleLee, Cha Len, Israt Jahan Riya, Ifrat Jahan Piya, Thiago Pimentel Muniz, Marcus Otho Butler, and Samuel David Saibil. 2025. "Immune Checkpoint Inhibitor-Induced Pancreatic Injury (ICI-PI) in Adult Cancer Patients: A Systematic Review and Meta-Analysis" Cancers 17, no. 7: 1080. https://doi.org/10.3390/cancers17071080
APA StyleLee, C. L., Riya, I. J., Piya, I. J., Muniz, T. P., Butler, M. O., & Saibil, S. D. (2025). Immune Checkpoint Inhibitor-Induced Pancreatic Injury (ICI-PI) in Adult Cancer Patients: A Systematic Review and Meta-Analysis. Cancers, 17(7), 1080. https://doi.org/10.3390/cancers17071080