Will antibody-drug conjugate and immune checkpoint inhibitor-based combination therapy close the gap between benefit and toxicity in the treatment of cancers? A systematic review and meta-analysis

Abstract Background Although antibody-drug conjugate (ADC) fosters hope for the treatment of cancer, the effect of single drug treatment is limited. Therefore, to achieve wider therapeutic effects, the combination of ADC and Immune checkpoint inhibitors (ICI) therapy may hold potential. Methods After literature retrieval, screening and data extraction, quality assessment was done by two investigators. Then, overall response rate (ORR) and adverse effects (AEs) were evaluated to study its efficiency and safety. Publication bias was also calculated through Funnel plot, Begg's Test and Egger's test. Meanwhile, heterogeneity was investigated through subgroup and sensitivity analysis. Results 11 eligible clinical studies with a total sample size of 551 were included. The pooled ORR was 59% (95% CI: 45% − 72%), especially in patients with relapsed classical Hodgkin lymphoma and patient treated with Brentuximab vedotin + Pembrolizumab. The most common AEs was peripheral neuropathy (38.2%) and AEs on skin (13.1% − 18.5%) and digestive system (8.7% − 28.1%) can not be overlooked. Conclusion ADC + ICI therapy may be recommended in cancer treatment, whereas strategies to manage toxicities warranted further exploration (PROSPERO CRD42023375601).