Sex and gender influence on adverse events for melanoma patients: a comprehensive review and meta-analysis
A partir d'une revue de la littérature publiée jusqu'en avril 2024 (69 études), cette méta-analyse évalue, en fonction du sexe, le risque d'événements indésirables liés aux immunothérapies et thérapies ciblées chez les patients atteints d'un mélanome
Immunotherapy (IMMUNO) and targeted therapy (TT) have revolutionised melanoma treatment. However, adverse events (AEs) remain frequent and may affect treatment adherence. Female sex has been linked to a higher risk of AEs in cytotoxic therapies. This systematic review and meta-analysis investigate the effect of Sex and Gender (S/G) on AEs during IMMUNO and/or TT in melanoma. Independent studies published up to April 2024 reporting toxicity by S/G in melanoma patients were included. Summary Odds Ratios (sOR) and 95% Confidence Intervals (CI) were calculated using random-effects models. Sixty-nine studies were included. Women had a significantly higher risk of thyroid-related AEs compared to men (sOR = 2.00, 95% CI: 1.41–2.82, I2 = 32%). No significant S/G differences were found for Grade III-IV, dermatological, gastrointestinal, hypophysis, kidney, liver, or ocular toxicities. This meta-analysis highlights a S/G based difference in the occurrence of thyroid-related AEs, particularly during first-line treatment. The observed association of dermatological AEs with TT in women, while intriguing, is based on limited evidence and should be considered hypothesis-generating. Overall, these findings suggest the need for closer monitoring of women for thyroid-related, dermatological, and severe AEs, with future studies warranted to confirm these signals in larger, adequately powered cohorts.
British Journal of Cancer , résumé, 2025