Safety profile of EZH2 inhibitors for cancer: a systematic review and meta-analysis

Objective To evaluate the safety profiles of EZH2-targeted inhibitors in cancer treatment, focusing on treatment-related adverse events (TRAEs) across various clinical trials. Methods We conducted a systematic review and meta-analysis using data from clinical trials involving EZH2 inhibitors reporte...

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Main Authors: Zhou Zhao, Xiufeng Chen, Huayang Pang, Yan Shi, Hao Sun
Format: Article
Language:English
Published: PeerJ Inc. 2025-01-01
Series:PeerJ
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Online Access:https://peerj.com/articles/18871.pdf
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author Zhou Zhao
Xiufeng Chen
Huayang Pang
Yan Shi
Hao Sun
author_facet Zhou Zhao
Xiufeng Chen
Huayang Pang
Yan Shi
Hao Sun
author_sort Zhou Zhao
collection DOAJ
description Objective To evaluate the safety profiles of EZH2-targeted inhibitors in cancer treatment, focusing on treatment-related adverse events (TRAEs) across various clinical trials. Methods We conducted a systematic review and meta-analysis using data from clinical trials involving EZH2 inhibitors reported up to May 31, 2024. Databases searched included PubMed, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), and ClinicalTrials.gov. Studies included were those involving patients treated with EZH2 inhibitors as monotherapy or in combination, specifically detailing the incidence of TRAEs. Data on all-grade TRAEs, grade 3 or higher TRAEs, and severe TRAEs were extracted and analyzed using random-effects models. Results Our systematic review and meta-analysis included 22 studies encompassing 1,002 patients who met the inclusion criteria. TRAEs were commonly observed during EZH2 inhibitor therapy, affecting 86% of patients (95% CI [79–94%]%; I2 = 89.5%). The incidence of grade 3 or higher TRAEs was 33% (95% CI [21–44%]; I2 = 93.5%), while severe TRAEs occurred in 15% of the cases (95% CI [9–22%]; I2 = 87.5%). The most frequently reported grade 3 or higher TRAEs in the pooled analysis were neutropenia (8%), thrombocytopenia (8%), and anemia (6%). Specifically, for tazemetostat, the most common grade 3 or higher TRAE was neutropenia (5%). For SHR2554, the most prevalent grade 3 or higher TRAEs were thrombocytopenia (17%), neutropenia (8%), and anemia (7%). Notably, treatment-related fatalities were rare, with only 0.9% of patients experiencing potentially fatal outcomes due to therapy. Conclusion EZH2 inhibitors demonstrate a manageable safety profile with a low incidence of severe TRAEs, emphasizing their potential as safe therapeutic options in cancer treatment. The low rate of severe TRAEs and the rare occurrences of treatment-related deaths support the continued clinical use and further investigation of EZH2 inhibitors.
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spelling doaj-art-7db959434d3c4194b1820945d67478372025-01-29T15:05:11ZengPeerJ Inc.PeerJ2167-83592025-01-0113e1887110.7717/peerj.18871Safety profile of EZH2 inhibitors for cancer: a systematic review and meta-analysisZhou Zhao0Xiufeng Chen1Huayang Pang2Yan Shi3Hao Sun4Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, ChinaGastrointestinal Cancer Center, Chongqing University Cancer Hospital, Chongqing, ChinaGastrointestinal Cancer Center, Chongqing University Cancer Hospital, Chongqing, ChinaDepartment of General Surgery, Center for Minimally Invasive Gastrointestinal Surgery, Southwest Hospital, Third Military Medical University, Chongqing, ChinaGastrointestinal Cancer Center, Chongqing University Cancer Hospital, Chongqing, ChinaObjective To evaluate the safety profiles of EZH2-targeted inhibitors in cancer treatment, focusing on treatment-related adverse events (TRAEs) across various clinical trials. Methods We conducted a systematic review and meta-analysis using data from clinical trials involving EZH2 inhibitors reported up to May 31, 2024. Databases searched included PubMed, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), and ClinicalTrials.gov. Studies included were those involving patients treated with EZH2 inhibitors as monotherapy or in combination, specifically detailing the incidence of TRAEs. Data on all-grade TRAEs, grade 3 or higher TRAEs, and severe TRAEs were extracted and analyzed using random-effects models. Results Our systematic review and meta-analysis included 22 studies encompassing 1,002 patients who met the inclusion criteria. TRAEs were commonly observed during EZH2 inhibitor therapy, affecting 86% of patients (95% CI [79–94%]%; I2 = 89.5%). The incidence of grade 3 or higher TRAEs was 33% (95% CI [21–44%]; I2 = 93.5%), while severe TRAEs occurred in 15% of the cases (95% CI [9–22%]; I2 = 87.5%). The most frequently reported grade 3 or higher TRAEs in the pooled analysis were neutropenia (8%), thrombocytopenia (8%), and anemia (6%). Specifically, for tazemetostat, the most common grade 3 or higher TRAE was neutropenia (5%). For SHR2554, the most prevalent grade 3 or higher TRAEs were thrombocytopenia (17%), neutropenia (8%), and anemia (7%). Notably, treatment-related fatalities were rare, with only 0.9% of patients experiencing potentially fatal outcomes due to therapy. Conclusion EZH2 inhibitors demonstrate a manageable safety profile with a low incidence of severe TRAEs, emphasizing their potential as safe therapeutic options in cancer treatment. The low rate of severe TRAEs and the rare occurrences of treatment-related deaths support the continued clinical use and further investigation of EZH2 inhibitors.https://peerj.com/articles/18871.pdfEZH2 inhibitorsSafety profileMeta-analysisSystematic reviewCancer
spellingShingle Zhou Zhao
Xiufeng Chen
Huayang Pang
Yan Shi
Hao Sun
Safety profile of EZH2 inhibitors for cancer: a systematic review and meta-analysis
PeerJ
EZH2 inhibitors
Safety profile
Meta-analysis
Systematic review
Cancer
title Safety profile of EZH2 inhibitors for cancer: a systematic review and meta-analysis
title_full Safety profile of EZH2 inhibitors for cancer: a systematic review and meta-analysis
title_fullStr Safety profile of EZH2 inhibitors for cancer: a systematic review and meta-analysis
title_full_unstemmed Safety profile of EZH2 inhibitors for cancer: a systematic review and meta-analysis
title_short Safety profile of EZH2 inhibitors for cancer: a systematic review and meta-analysis
title_sort safety profile of ezh2 inhibitors for cancer a systematic review and meta analysis
topic EZH2 inhibitors
Safety profile
Meta-analysis
Systematic review
Cancer
url https://peerj.com/articles/18871.pdf
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