Acetaminophen use and prognosis in cancer patients treated with immune checkpoint inhibitors: evidence from a meta-analysis
Abstract
Background: Emerging studies have investigated the association between acetaminophen (APAP) use and clinical outcomes in cancer patients receiving immune checkpoint inhibitors (ICIs), but their findings remain inconsistent. This meta-analysis aims to systematically synthesize available evidence to clarify this relationship and provide evidence-based guidance for clinical practice.
Methods: A systematic literature search was performed to identify studies comparing prognostic outcomes between APAP users and non-users among cancer patients treated with ICIs. Eligible studies were required to report hazard ratios (HRs) for overall survival (OS) and/or progression-free survival (PFS) with 95% confidence intervals (CIs). Meta-analyses were conducted to derive pooled effect estimates. Funnel plots and Egger's test were used to assess publication bias, and sensitivity analyses via a leave-one-out approach were performed to evaluate the robustness of results.
Results: Five studies encompassing 7 cohorts and 2,349 patients (1,306 APAP users and 1,043 non-users) were included. Pooled analyses revealed that concomitant APAP use was significantly associated with shorter OS (HR: 1.29; 95% CI: 1.16-1.44) and PFS (HR: 1.27; 95% CI: 1.12-1.43), as well as a trend toward a lower objective response rate (RR: 0.78; 95% CI: 0.60-1.00). No significant publication bias was detected, and sensitivity analyses confirmed the robustness of these findings.
Conclusion: Current evidence indicates that…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 2,349 participants or records.
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