Neuropathy with vascular endothelial growth factor receptor tyrosine kinase inhibitors: A meta-analysis. (9th July 2019)

• Record Type: Journal Article
• Authors: Roy, Bhaskar; Das, Avash; Ashish, Kumar; Bandyopadhyay, Dhrubajyoti; Maiti, Abhishek; Chakraborty, Sandipan; Stone, Martha E.; Philpotts, Lisa Liang; Nowak, Richard J.; Patwa, Huned S.
• Is Part Of: Neurology. Volume 93:Number 2(2019)
• Publication Date: 2019-07-09
• Subjects: Neurology -- Periodicals; Neurology -- Periodicals; Neurologie -- Périodiques; 616.8
• DOI: 10.1212/WNL.0000000000007743
• Languages: English
• ISSNs: 0028-3878

Abstract

Abstract : Objective: To explore the association of peripheral neuropathy with vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) use in patients with cancer. Methods: Published data search up to November 2018 reporting peripheral neuropathy in patients with cancer treated with VEGFR-TKIs was performed. The primary outcome was presence of peripheral neuropathy at the end of the trial. Random-effects meta-analysis was performed to estimate relative risk (RR) of individual treatment. Results: Thirty randomized clinical trials (RCTs) including 12, 490 patients with cancer were included in this analysis. Eight studies compared VEGFR-TKIs with placebo and the remaining studies compared VEGFR-TKIs with the standard chemotherapeutic regimen. When compared against placebo, VEGFR-TKIs were associated with a higher risk of peripheral neuropathy (RR 1.76; 95% confidence interval [CI] 1.13–2.75, p = 0.01). Similarly, a stronger association was noted for sensory neuropathy with VEGFR-TKIs monotherapy (RR 1.61; 95% CI 1.09–2.37, p = 0.02). Risk of peripheral neuropathy with VEGFR-TKIs was higher even when they were compared against control (either placebo or standard chemotherapeutic agents) (RR 1.08; 95% CI 1.01–1.15, p = 0.03). High-grade neuropathy (RR 1.28; 95% CI 1.06–1.54, p <0.01) and high-grade sensory neuropathy (RR 1.38; 95% CI 1.09–1.74, p < 0.01) were noted more frequently with VEGFR-TKIs treatment compared against control. Conclusions: VEGFR-TKIs therapy appeared to be associated with an increased risk of neuropathy.