The Pattern of Time to Onset and Resolution of Immune-Related Adverse Events Caused by Immune Checkpoint Inhibitors in Cancer: A Pooled Analysis of 23 Clinical Trials and 8,436 Patients

PURPOSE

The occurrence pattern of immune-related adverse events (irAEs) induced by immune checkpoint inhibitor (ICI) in cancer treatment remains unclear.

Materials and Methods

Phase II-III clinical trials that evaluated ICI-based treatments in cancer and were published between January 2007 and December 2019 were retrieved from public electronic databases. The pooled median time to onset (PMT-O), resolution (PMT-R), and immune-modulation resolution (PMT-IMR) of irAEs were generated using the metamedian package of R software.

RESULTS

Twenty-two eligible studies involving 23 clinical trials and 8,436 patients were included. The PMT-O of all-grade irAEs ranged from 2.2 to 14.8 weeks, with the longest in renal events. The PMT-O of grade ≥ 3 irAEs was significantly longer than that of all-grade irAEs induced by programmed cell death protein 1 (PD-1) and its ligand 1 (PD-L1) inhibitors (27.5 weeks vs. 8.4 weeks, p < 0.001) and treatment of nivolumab (NIV) plus ipilimumab (IPI) (7.9 weeks vs. 6.0 weeks, p < 0.001). The PMT-R of all-grade irAEs ranged from 0.1 to 54.3 weeks, with the shortest and longest in hypersensitivity/infusion reaction and endocrine events, respectively. The PMT-IMR of grade ≥ 3 irAEs was significantly shorter than that of all-grade irAEs caused by PD-1/PD-L1 blockade (6.9 weeks vs. 40.6 weeks, p=0.002) and NIV+IPI treatment (3.1 weeks vs. 5.9 weeks, p=0.031).

CONCLUSION

This study revealed the general and specific occurrence pattern of ICI-induced irAEs in pan-cancers, which was deemed to aid the comprehensive understanding, timely detection, and effective management of ICI-induced irAEs.

Occurrence patterns of black water and its impact on fish in cutover areas of Eucalyptus plantations

Black runoff occasionally flows from cutover areas of Eucalyptus plantations, polluting rivers and ponds, and resulting in fish death in severe cases. However, the occurrence patterns and environmental impacts of this black water remain unclear. Herein, we analyzed the major characteristics of black water at the occurrence sites, tested the complexation reaction of ground eucalyptus leaves with a solution of Fe³⁺, and determined the color and absorbance of the complex solution. The results showed that the water was dark blue, with weak acidity and strong light absorbance. The water contained a high level of dissolved organic matter content, while its chemical oxygen demand, total N, total P, NO₃^--N, and NH₄⁺-N concentrations were significantly higher than those in the stream water from Eucalyptus, Pinus massoniana Lamb., and Cunninghamia lanceolata stands during the growth period. Additionally, the tannic acid concentration in the black water was 1.0 mg L^-1 higher than that in the stream water from the Eucalyptus stand. The input of black water increases the concentration of tannic acid and NH⁴⁺-N, and the degradation of organic matter consumes dissolved oxygen in downstream ponds, leading to fish deaths. The presence of fresh logging residues and hot, humid weather also enable black water formation. Field investigations and simulation experiments revealed fresh Eucalyptus residues decompose rapidly under high-temperature and rainfall conditions, releasing large amounts of tannic acid, which reacts with Fe³⁺ to form a dark blue tannic acid‑iron complex and results in black water. These results indicate that the rich Fe³⁺ in runoff may be a key factor in the occurrence of black water. The logging of Eucalyptus plantations during the dry season or on non-rainy days and a reduction in the logging area could prevent the occurrence of black water or mitigate the extent of its environmental hazards.

Systematic review and meta-analysis of congenitally missing permanent dentition: Sex dimorphism, occurrence patterns, associated factors and biasing factors

PURPOSE

We aimed to summarize/analyze, comprehensively and for the first time, the literature on the prevalence of congenitally missing teeth (CMT) in males and females and the CMT pattern, taking various associated and biasing factors into account.

METHODS

A search was performed independently by two authors during September 2012 till June 2013 to find all the available literature regarding CMT-associated factors and patterns comprising sex dimorphism, arches, anterior/posterior regions, unilateral/bilateral patterns, and involved teeth. The data were statistically analyzed.

RESULTS

Seventy-four studies were included. The mean CMT prevalence was 6.42±2.76% in males and 7.55±2.67% in females. Overall, CMT is more prevalent in females but only in epidemiological samples, and not in orthodontic or dental patients. Enrolling orthodontic/dental patients might increase the observed CMT in boys and/or reduce it in girls. Gender dimorphism was not affected by any of the factors: time, regions, or the biasing factors. There is not a significant predominance of maxillary or mandibular involvement, although the anterior segment is more likely to be affected.

CONCLUSIONS

CMT is more common in girls and in the anterior segment, regardless of the date of publication. Contrary to the commonly held belief regarding more CMT prevalence in female orthodontic patients, it was shown that in dental/orthodontic patients, CMT prevalence is higher in boys.