Adverse events risk associated with anti-VEGFR agents in the treatment of advanced nonsmall-cell lung cancer: A meta-analysis. Issue 48 (November 2016)

• Record Type: Journal Article
• Authors: Gu, Biao; Gao, WenChuang; Chu, HongJun; Gao, Jian; Fu, Zhi; Ding, Hui; Lv, JunJie; Wu, QingQuan
• Other Names: Lorenzo Giuseppe Di section editor.
• Is Part Of: Medicine. Volume 95:Issue 48(2016)
• Publication Date: 2016-11
• Subjects: adverse events -- angiogenesis inhibitor -- anti-VEGFR agents -- meta-analysis -- nonsmall-cell lung cancer -- safety; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000003752
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Abstract: To perform this meta-analysis, we investigated the risk of the most clinically relevant adverse events related to antivascular endothelial growth factor receptor (VEGFR) agents in advanced nonsmall-cell lung cancer (NSCLC). A comprehensive literature search for studies published up to October 2015 was performed. Prospective randomized controlled phase II/III clinical trials that comparing therapy with or without anti-VEGFR agents for advanced NSCLC were included for analysis. Summary relative risk (RR) and 95% confidence intervals (CIs) were calculated using random effects or fixed effects according to the heterogeneity among included trials. A total of 11, 701 patients from 18 clinical trials were included for analysis. Pooled RR showed that the use of anti-VEGFR agents significantly increased the risk of developing hypertension (RR 4.71, 95% CI 3.29–6.73, P < 0.001) and fatal adverse events (RR 1.33, 95% CI 1.12–1.58, P = 0.001). No statistically significant differences were found for gastrointestinal (GI) perforation ( P = 0.41), arterial or venous thromboembolic events ( P = 0.49 and P = 0.16, respectively), or hemorrhagic events ( P = 0.81). Sensitive analysis indicated that the significance estimate of pooled RR of fatal adverse event (FAEs) was not significantly influenced by omitting any single study. The use of anti-VEGFR agents in advanced NSCLC does significantly increase the risk of hypertension and fatal adverse events, but not for arterial or venous thromboembolic events, GI perforation, or hemorrhagic events. Abstract : Supplemental Digital Content is available in the text