Evidence map›Paper›PMID 40469302›Full record

SynthesisFrontiers in immunology2025

Risk factors for checkpoint inhibitor pneumonitis in lung cancer patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis.

Xiaoqing Zhou, Yingnan Xu, Yuanyuan Ying, Ruilin Chen, Zhen Wang, Xin Lv

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Frontiers in immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed.

  1. Review
  2. [Advances in Radiomics for Immune Checkpoint Inhibitor-related Pneumonitis 
of Lung Cancer].Zhongguo fei ai za zhi = Chinese journal of lung cancer · 2026
    Review
  3. Article
  4. Article
  5. Article
  6. Article
  7. Pulmonary toxicity of immune checkpoint inhibitors.Breathe (Sheffield, England) · 2026
    Review
  8. When Checkpoint Inhibitors Break Barriers: Mechanisms and Challenges of irAEs of the Skin, Gastrointestinal Tract, and Lung.Clinical cancer research : an official journal of the American Association for Cancer Research · 2026
    Review
  9. The management of rheumatic immune related adverse events.Best practice & research. Clinical rheumatology · 2026
    Review
  10. Review
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Xiaoqing Zhou *The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China.
Yingnan Xu *The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Yuanyuan YingThe First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Ruilin ChenThe First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China.
Zhen WangThe First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China.
Xin LvThe First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Immune checkpoint inhibitors (ICIs) significantly improve survival in lung cancer patients. However, checkpoint inhibitor pneumonitis (CIP) remains a critical safety concern. This meta-analysis systematically evaluates demographic, clinical, and laboratory risk factors associated with CIP development to guide risk-stratified management. Methods: We systematically searched eight databases from inception to February 20, 2025. Study quality was assessed using the NOS. Adjusted risk factors from multivariate analyses were pooled in RevMan 5.4. Sensitivity analyses addressed heterogeneity, and funnel plots evaluated publication bias. Results: 28 NOS-certified high-quality studies were included. 20 risk factors comprised: advanced age, male sex, smoking status, preexisting interstitial lung abnormalities, pulmonary fibrosis, COPD, thoracic radiotherapy history, squamous cell carcinoma histology (versus adenocarcinoma), early-stage NSCLC (Stage III versus IV), multifocal metastases (≥2 sites), PD-1 inhibitors (versus PD-L1 agents), elevated PD-L1 expression (≥50%), pembrolizumab use (versus nivolumab), AEC, CRP, PLR, WBC, and hypoalbuminemia. Sensitivity analyses confirmed consistency between FEM and REM; funnel plots indicated no publication bias. Conclusion: This study identifies 20 independent CIP risk factors in ICI-treated lung cancer patients. Early screening and intervention for high-risk populations are critical to reducing CIP incidence and improving clinical outcomes. These findings provide actionable insights for optimizing ICI safety in real-world practice. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/myprospero, identifier CRD420250655469.

Indexed as

Immune Checkpoint InhibitorsLung NeoplasmsPneumoniaFemaleHumansMaleRisk FactorsImmune Checkpoint Inhibitorscheckpoint inhibitor pneumonitisimmune checkpoint inhibitorsimmune-related adverse eventsmeta-analysisrisk factor

Identifiers

PMID40469302
PMCPMC12133883

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.