Treatment-related toxicities of apatinib in solid tumors: a meta-analysis
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Ling Peng1, Xianghua Ye2, Yun Hong3, Junyan Zhang4, Yongquan Dong5 and Qiong Zhao1
1Department of Thoracic Oncology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
2Department of Radiotherapy, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
3Department of Pharmacy, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
4Bothwin Clinical Study Consultant, Bellevue, WA, USA
5Department of Respiratory Disease, Yinzhou No.2 Hospital, Ningbo, Zhejiang Province, China
Qiong Zhao, email: email@example.com
Keywords: apatinib; hypertension; proteinuria; hand-foot-syndrome; meta-analysis
Received: July 19, 2017 Accepted: November 03, 2017 Epub: January 13, 2018 Published: August 14, 2018
Background: Apatinib is a novel small molecular drug targeting vascular endothelial growth factor receptor-2 (VEGFR-2), which is being studied in multiple tumor types. We performed a meta-analysis to quantify the overall incidence and risk of hypertension, proteinuria, and hand-foot-syndrome (HFS) in cancer patients receiving apatinib.
Results: Altogether, 820 cancer patients from 7 prospective trials were included for the meta-analysis. The incidences of all-grade and high-grade hypertension were 45.4% and 9.7%. The incidences of all-grade and high-grade proteinuria were 45.1% and 3.7%. The incidences of all-grade and high-grade HFS were 35.9% and 8.6%. The RRs of all-grade hypertension, proteinuria and HFS of apatinib compared to placebo were increased (hypertension, RR = 6.53; proteinuria, RR = 2.62, and HFS, RR = 11.45). The RRs of developing high-grade hypertension and HFS were substantially higher than that of placebo (hypertension, RR = 7.73; HFS, RR = 7.23), but not for proteinuria (RR = 2.56, 95% CI: 0.57–11.52).
Materials and Methods: Prospective phase II and III clinical trials of cancer patients receiving apatinib were searched and included. Summary incidences, relative risk (RR), and 95% confidence intervals (CI) were calculated by using either fixed or random effects models according to the heterogeneity of the studies.
Conclusions: Apatinib is generally well tolerated, and associated with increased risks of all-grade hypertension, proteinuria and HFS, and high-grade hypertension and HFS, but not high-grade proteinuria.
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