Real-world study on adverse drug reactions of pembrolizumab in endometrial cancer treatment: insights from the FAERS database

ObjectivePembrolizumab is a key drug in the immunotherapy of endometrial cancer (EC) and has improved the prognosis to some extent. However, adverse drug events (ADEs) have hindered the achievement of expected therapeutic outcomes in EC. This study, therefore, aims to investigate the ADEs of pembrol...

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Main Authors: Huiping Zhang, Man Di, Jingjing Wang, Shan Wang, Yini Dai, Jingjing Huang, Zhuo Zhou
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Pharmacology
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Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2025.1622339/full
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author Huiping Zhang
Man Di
Jingjing Wang
Shan Wang
Yini Dai
Jingjing Huang
Zhuo Zhou
author_facet Huiping Zhang
Man Di
Jingjing Wang
Shan Wang
Yini Dai
Jingjing Huang
Zhuo Zhou
author_sort Huiping Zhang
collection DOAJ
description ObjectivePembrolizumab is a key drug in the immunotherapy of endometrial cancer (EC) and has improved the prognosis to some extent. However, adverse drug events (ADEs) have hindered the achievement of expected therapeutic outcomes in EC. This study, therefore, aims to investigate the ADEs of pembrolizumab using the FAERS database, offering new insights for clinical practice in EC treatment.MethodFrom the first quarter of 2016 to the first quarter of 2025, ADEs associated with pembrolizumab in EC were collected from the FAERS database. The Reporting Odds Ratio (ROR) was used as the primary analytical method for signal detection. To validate the robustness of the results, three additional algorithms—Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-Item Gamma Poisson Shrinker (MGPS)—were also applied. ADEs were systematically classified using the Medical Dictionary for Regulatory Activities (MedDRA) into System Organ Classes (SOC) and Preferred Terms (PT), and ranked by both frequency and signal strength.ResultsA total of 2,154 ADEs associated with pembrolizumab in the treatment of EC were retrieved from the FAERS database. The age distribution of ADEs was primarily concentrated in the 65–85 years age group. The reported body weights were mainly in the 50–100 kg range. The most frequent ADE outcome was hospitalization. The majority of ADEs occurred within 0–30 days after pembrolizumab administration. Identified ADEs involved endocrine system disorders, including Increased Thyroid Hormones (ROR = 9.22), Decreased Thyroid Hormones (ROR = 5.31), and Immune-Mediated Hypothyroidism (ROR = 6.16). Skin and subcutaneous tissue disorders included Pruritic Rash (ROR = 3.16) and Blisters (ROR = 3.06). Liver-related issues included Increased Hepatic Enzymes (ROR = 2.25). These key signals were consistently confirmed by additional disproportionality algorithms, including PRR, BCPNN, and MGPS, reinforcing the robustness of the findings.ConclusionThis study used the FAERS database to identify frequently reported ADEs associated with pembrolizumab in the treatment of EC, including endocrine system diseases, musculoskeletal system disorders, skin and subcutaneous tissue reactions, and hepatotoxicity. These findings provide crucial evidence for risk stratification and safety monitoring in clinical practice, emphasizing the need for vigilance toward specific organ systems during the 0–30-day treatment window.
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spelling doaj-art-fd1de64c0dbe4e9e82c24a76ba2b866e2025-08-20T03:05:53ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-08-011610.3389/fphar.2025.16223391622339Real-world study on adverse drug reactions of pembrolizumab in endometrial cancer treatment: insights from the FAERS databaseHuiping Zhang0Man Di1Jingjing Wang2Shan Wang3Yini Dai4Jingjing Huang5Zhuo Zhou6Department of Obstetrics and Gynecology, Northwest University First Hospital, Xi’an, Shaanxi, ChinaDepartment of Obstetrics and Gynecology, Tangdu Hospital, Air Force Medical University, Xi’an, Shaanxi, ChinaDepartment of Obstetrics and Gynecology, Tangdu Hospital, Air Force Medical University, Xi’an, Shaanxi, ChinaDepartment of Obstetrics and Gynecology, Northwest University First Hospital, Xi’an, Shaanxi, ChinaDepartment of Pharmacy, Northwest University First Hospital, Xi’an, Shaanxi, ChinaDepartment of Pharmacy, Northwest University First Hospital, Xi’an, Shaanxi, ChinaDepartment of Obstetrics and Gynecology, Northwest University First Hospital, Xi’an, Shaanxi, ChinaObjectivePembrolizumab is a key drug in the immunotherapy of endometrial cancer (EC) and has improved the prognosis to some extent. However, adverse drug events (ADEs) have hindered the achievement of expected therapeutic outcomes in EC. This study, therefore, aims to investigate the ADEs of pembrolizumab using the FAERS database, offering new insights for clinical practice in EC treatment.MethodFrom the first quarter of 2016 to the first quarter of 2025, ADEs associated with pembrolizumab in EC were collected from the FAERS database. The Reporting Odds Ratio (ROR) was used as the primary analytical method for signal detection. To validate the robustness of the results, three additional algorithms—Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-Item Gamma Poisson Shrinker (MGPS)—were also applied. ADEs were systematically classified using the Medical Dictionary for Regulatory Activities (MedDRA) into System Organ Classes (SOC) and Preferred Terms (PT), and ranked by both frequency and signal strength.ResultsA total of 2,154 ADEs associated with pembrolizumab in the treatment of EC were retrieved from the FAERS database. The age distribution of ADEs was primarily concentrated in the 65–85 years age group. The reported body weights were mainly in the 50–100 kg range. The most frequent ADE outcome was hospitalization. The majority of ADEs occurred within 0–30 days after pembrolizumab administration. Identified ADEs involved endocrine system disorders, including Increased Thyroid Hormones (ROR = 9.22), Decreased Thyroid Hormones (ROR = 5.31), and Immune-Mediated Hypothyroidism (ROR = 6.16). Skin and subcutaneous tissue disorders included Pruritic Rash (ROR = 3.16) and Blisters (ROR = 3.06). Liver-related issues included Increased Hepatic Enzymes (ROR = 2.25). These key signals were consistently confirmed by additional disproportionality algorithms, including PRR, BCPNN, and MGPS, reinforcing the robustness of the findings.ConclusionThis study used the FAERS database to identify frequently reported ADEs associated with pembrolizumab in the treatment of EC, including endocrine system diseases, musculoskeletal system disorders, skin and subcutaneous tissue reactions, and hepatotoxicity. These findings provide crucial evidence for risk stratification and safety monitoring in clinical practice, emphasizing the need for vigilance toward specific organ systems during the 0–30-day treatment window.https://www.frontiersin.org/articles/10.3389/fphar.2025.1622339/fullpembrolizumabendometrial cancerimmunotherapyimmune checkpoint inhibitorsimmune-related adverse events
spellingShingle Huiping Zhang
Man Di
Jingjing Wang
Shan Wang
Yini Dai
Jingjing Huang
Zhuo Zhou
Real-world study on adverse drug reactions of pembrolizumab in endometrial cancer treatment: insights from the FAERS database
Frontiers in Pharmacology
pembrolizumab
endometrial cancer
immunotherapy
immune checkpoint inhibitors
immune-related adverse events
title Real-world study on adverse drug reactions of pembrolizumab in endometrial cancer treatment: insights from the FAERS database
title_full Real-world study on adverse drug reactions of pembrolizumab in endometrial cancer treatment: insights from the FAERS database
title_fullStr Real-world study on adverse drug reactions of pembrolizumab in endometrial cancer treatment: insights from the FAERS database
title_full_unstemmed Real-world study on adverse drug reactions of pembrolizumab in endometrial cancer treatment: insights from the FAERS database
title_short Real-world study on adverse drug reactions of pembrolizumab in endometrial cancer treatment: insights from the FAERS database
title_sort real world study on adverse drug reactions of pembrolizumab in endometrial cancer treatment insights from the faers database
topic pembrolizumab
endometrial cancer
immunotherapy
immune checkpoint inhibitors
immune-related adverse events
url https://www.frontiersin.org/articles/10.3389/fphar.2025.1622339/full
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