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Women experience more adverse events from chemotherapy than men. However, only a handful of research studies have explored sex differences in immune or targeted therapies. This study, published in the Journal of Clinical Oncology, examines adverse events by sex across these different types of cancer treatment. 

The researchers looked at treatment-related adverse events by sex in Southwest Oncology Group (SWOG) phase II and III clinical trials between 1980 and 2019, excluding sex-specific cancers. Adverse event codes and grades were categorized using the Common Terminology Criteria for Adverse Events. Thirteen symptomatic and fourteen objective adverse event categories were examined. Multivariable logistic regression was used to adjust for age, disease prognosis, and race.

Ultimately, out of 23,296 patients from 202 trials, it was found that 65% experienced one or more severe (grade ≥ 3) adverse events. Female participants, in particular, had a 34% increased risk of severe adverse events than male participants, including a 49% increased risk when receiving immunotherapy. 

Overall, women experienced an increased risk of severe symptomatic adverse events with all treatments, especially immunotherapy. In addition, women receiving chemotherapy or immunotherapy had more severe hematologic adverse events. No statistically significant sex differences in the risk of nonhematologic adverse events were found. 

These findings indicate that sex differences exist in response to cancer treatments. These differences may be connected to reported adverse events, pharmacogenomics of drug metabolism/disposition, total dose received, and adherence to therapy. 

In closing, this study suggests that healthcare providers can better serve their female patients with cancer by considering the severity of the potential adverse events they may experience from treatment and carefully weighing each treatment option with their patients [1].

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[1] Unger, J. M., Vaidya, R., Albain, K. S., LeBlanc, M., Minasian, L. M., Gotay, C. C., Henry, N. L., Fisch, M. J., Lee, S. M., Blanke, C. D., & Hershman, D. L. (2022). Sex differences in risk of severe adverse events in patients receiving immunotherapy, targeted therapy, or chemotherapy in cancer clinical trials. Journal of Clinical Oncology. https://doi.org/10.1200/jco.21.02377