{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T16:59:23Z","timestamp":1790787563258,"version":"4.1.0"},"reference-count":65,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T00:00:00Z","timestamp":1742774400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Immune checkpoint inhibitor-induced pancreatic injury (ICI-PI) is a rare immunotoxicity, with limited data on treatment and long-term outcomes. Methods: PubMed, EMBASE, and Cochrane Library were systematically searched for studies reporting ICI-PI in patients with solid malignancies. ICI-PI was defined as pancreatic inflammation post-ICI exposure, diagnosed via radiologic changes or elevated lipase\/amylase levels without other underlying causes. The CTCAE grading system was used. The primary objectives were to assess the frequency, severity, serum abnormalities, management, and long-term outcomes. We conducted a proportional single-arm meta-analysis with a random effects model. Results: The analysis included 25 retrospective studies involving 48,704 patients. Tumor types included thoracic\/head and neck (38%), skin (26%), genitourinary\/gynecological (18%), gastrointestinal (12%), and others (6%). The median age ranged from 56 to 73 years, with a follow-up from 2.5 to 45.9 months. ICI-PI occurred in 3.60% (95% CI: 1.64\u20136.28%) of patients, with grade \u2265 3 toxicity in 59.45% (95% CI: 35.32\u201381.37%). The frequency rates of ICI-PI were 1.99% for CTLA4 inhibitors, 5.01% for PD(L)1 inhibitors, and 7.44% for combination ICI therapy (p &lt; 0.01). The median time to onset from treatment initiation ranged from 30 to 390 days, and symptom resolution ranged from 55 to 84 days. Management included corticosteroids (30.20%), intravenous fluids (22.82%), and hospitalization (30.46%). Chronic complications affected 63.54% (95% CI: 29.03\u201391.56%), including primarily diabetes mellitus (DM 89.45%; 95% CI: 61.88\u2013100.0%) and exocrine pancreatic insufficiency (EPI 10.55%; 95%: 0.0\u201338.12%). ICI-PI recurrence occurred in 27.2% of those resuming ICI therapy. The objective response rate was 61.7% (95% CI: 55.08\u201368.17%). Conclusions: ICI-PI, though infrequent, is severe and predisposes patients to chronic complications, including DM and EPI.<\/jats:p>","DOI":"10.3390\/cancers17071080","type":"journal-article","created":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T04:48:18Z","timestamp":1742791698000},"page":"1080","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Immune Checkpoint Inhibitor-Induced Pancreatic Injury (ICI-PI) in Adult Cancer Patients: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3919-7539","authenticated-orcid":false,"given":"Cha Len","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Medical Oncology and Hematology, CancerCare Manitoba, University of Manitoba, Winnipeg, MB R2H 2A6, Canada"},{"name":"Division of Medical Oncology and Hematology, Princess Margaret Cancer Center, University of Toronto, University Health Network, Toronto, ON M5S 1Z5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2668-3945","authenticated-orcid":false,"given":"Israt Jahan","family":"Riya","sequence":"additional","affiliation":[{"name":"Dhaka Medical College Hospital, Dhaka 1000, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1577-7056","authenticated-orcid":false,"given":"Ifrat Jahan","family":"Piya","sequence":"additional","affiliation":[{"name":"Dhaka Medical College Hospital, Dhaka 1000, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thiago Pimentel","family":"Muniz","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology and Hematology, Princess Margaret Cancer Center, University of Toronto, University Health Network, Toronto, ON M5S 1Z5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9840-7057","authenticated-orcid":false,"given":"Marcus Otho","family":"Butler","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology and Hematology, Princess Margaret Cancer Center, University of Toronto, University Health Network, Toronto, ON M5S 1Z5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel David","family":"Saibil","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology and Hematology, Princess Margaret Cancer Center, University of Toronto, University Health Network, Toronto, ON M5S 1Z5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3044","DOI":"10.3390\/curroncol29050247","article-title":"Immune Checkpoint Inhibitors in Cancer Therapy","volume":"29","author":"Shiravand","year":"2022","journal-title":"Curr. 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