e21542Background: Immunotherapy and target therapy have revolutionized melanoma treatment. However, adverse events (AEs) are still frequent and might impact treatment adherence. Female sex was demonstrated to be associated with a higher risk of AEs from cytotoxic therapy related to cancer treatment. This study aims to conduct a systematic review and meta-analysis to investigate Sex and Gender (S/G) effect on adverse events. Methods: We extracted data from independent studies published until April 2024 with information regarding toxicity by S/G. Only studies that involved patients with melanoma as primary disease were included. Summary Odds ratios OR (sOR) estimates were obtained through random-effects models, and 95% Confidence Intervals (CI) were estimated. I2 was used to evaluate the between-study heterogeneity. Publication bias was investigated with Begg and Egger tests. Results: Information regarding toxicity and gender were extracted from seventy articles. A significant increase in AE related to the thyroid was observed in women (sOR = 2.01, 95%CI [1.41-2.85], I² = 29). S/G did not affect Grade III-IV, Dermatological, Gastrointestinal, Hypophyses, Kidney, Liver or Ocular toxicities. The increased risk of AE related to the thyroid was mainly seen in those undergoing first-line treatments, sOR =, 2.16 [1.36-3.42], and those who underwent mono and combo therapy. Women undergoing TT (target therapy) had an increased risk of dermatological (sOR = 1.94, 95%CI 1.51-2.50, I² = 0%) AE. Conclusions: This study supports and extends the discussion on the impact of S/G on the development of toxicities. Women have an increased risk of AE related to the thyroid, mainly seen during first-line treatment, and showed an increased risk of dermatological AE when treated with TT. Women should be monitored closely for precursor signs of thyroid-related AE, as well as dermatological and generally severe AE, to preserve good treatment adherence.
Queirolo, P., Gaeta, A., Nuvoli, L., Saponara, M., Cimminiello, C., Carretti, M., et al. (2025). Sex and gender influence on adverse events for melanoma patients: A comprehensive review and meta-analysis. In 2025 ASCO Annual Meeting (pp.21542-21542). Lippincott Williams and Wilkins [10.1200/JCO.2025.43.16_suppl.e21542].
Sex and gender influence on adverse events for melanoma patients: A comprehensive review and meta-analysis
Gaeta A.Co-primo
;
2025
Abstract
e21542Background: Immunotherapy and target therapy have revolutionized melanoma treatment. However, adverse events (AEs) are still frequent and might impact treatment adherence. Female sex was demonstrated to be associated with a higher risk of AEs from cytotoxic therapy related to cancer treatment. This study aims to conduct a systematic review and meta-analysis to investigate Sex and Gender (S/G) effect on adverse events. Methods: We extracted data from independent studies published until April 2024 with information regarding toxicity by S/G. Only studies that involved patients with melanoma as primary disease were included. Summary Odds ratios OR (sOR) estimates were obtained through random-effects models, and 95% Confidence Intervals (CI) were estimated. I2 was used to evaluate the between-study heterogeneity. Publication bias was investigated with Begg and Egger tests. Results: Information regarding toxicity and gender were extracted from seventy articles. A significant increase in AE related to the thyroid was observed in women (sOR = 2.01, 95%CI [1.41-2.85], I² = 29). S/G did not affect Grade III-IV, Dermatological, Gastrointestinal, Hypophyses, Kidney, Liver or Ocular toxicities. The increased risk of AE related to the thyroid was mainly seen in those undergoing first-line treatments, sOR =, 2.16 [1.36-3.42], and those who underwent mono and combo therapy. Women undergoing TT (target therapy) had an increased risk of dermatological (sOR = 1.94, 95%CI 1.51-2.50, I² = 0%) AE. Conclusions: This study supports and extends the discussion on the impact of S/G on the development of toxicities. Women have an increased risk of AE related to the thyroid, mainly seen during first-line treatment, and showed an increased risk of dermatological AE when treated with TT. Women should be monitored closely for precursor signs of thyroid-related AE, as well as dermatological and generally severe AE, to preserve good treatment adherence.
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