1. Targeted therapy for solid tumors and risk of hypertension: a meta-analysis of 68077 patients from 93 phase III studies
- Author
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Jarno Morbiducci, Alessandro Conti, Liang Cheng, Luca Faloppi, Sebastiano Buti, Francesco Piva, Matteo Santoni, Francesco Massari, Antonio Lopez-Beltran, Vincenzo Di Nunno, Rodolfo Montironi, Nicola Battelli, Eva Galizia, Roberto Iacovelli, Benedetta Ferretti, Alessia Cimadamore, and Marina Scarpelli
- Subjects
Risk ,medicine.medical_specialty ,Bevacizumab ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Targeted therapy ,Cardiovascular events ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Internal medicine ,Neoplasms ,Internal Medicine ,medicine ,Humans ,Clinical Trials ,030212 general & internal medicine ,Molecular Targeted Therapy ,Adverse effect ,Cancer ,Randomized Controlled Trials as Topic ,Cervical cancer ,business.industry ,Incidence ,General Medicine ,medicine.disease ,Hypertension ,Meta-analysis ,Phase III as Topic ,Clinical trial ,Clinical Trials, Phase III as Topic ,Relative risk ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
Objective: Hypertension is a common adverse event with targeted agents in cancer patients and can lead to serious and sometimes lethal cardiovascular complications. The authors performed a meta-analysis of clinical trials aiming to evaluate the incidence and Relative Risk (RR) of developing all-grade and high-grade Hypertension Events (HE) in patients with solid tumors receiving targeted therapy.Methods: A review of citations from PubMed was performed and studies were selected based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The search was limited to randomized phase III trials published in English focused on the efficacy and safety of targeted agents in cancer patients, reporting data on HE. Incidence, RR and relative 95% CIs were analyzed using random or fixed-effects models. Overall incidences were calculated and further compared with the chi-squared test for proportions.Results: Ninety-three phase III trials were included, with a total of 68,077 patients. Prostate cancer was the most represented (18.9%), followed by breast cancer (17.3%) and colorectal cancer (16.4%). The incidence of all- and high-grade HE was 23.47% and 8.57%, respectively, with the highest incidence of serious HE reported by adjuvant Sunitib/Sorafenib (29.03%). The highest RR of high-grade HE was observed with Bevacizumab in patients with advanced cervical cancer. By drug category, the highest RR of high-grade HE was reported by VEGFR/EGFR TKIs.Conclusion: According to these data, monitoring this class of toxicities is of primary importance to avoid hypertension worsening and, thus, the risk of major cardiovascular events.
- Published
- 2019