Risk of gastrointestinal events with sorafenib, sunitinib and pazopanib in patients with solid tumors: A systematic review and meta-analysis of clinical trials

Matteo Santoni, Alessandro Conti, Ugo De Giorgi, Roberto Iacovelli, Francesco Pantano, Luciano Burattini, Giovanni Muzzonigro, Rossana Berardi, Daniele Santini, Stefano Cascinu

Research output: Contribution to journalArticle

Abstract

Gastrointestinal (GI) events have been described with sorafenib, sunitinib and pazopanib in cancer patients. We performed an up-to-date meta-analysis to determine the incidence and relative risk (RR) in patients with cancer treated with these agents. PubMed databases were searched for articles published till May 2013. Eligible studies were selected according to PRISMA statement. Summary incidence, RR, and 95% CIs were calculated using random-effects or fixed-effects models based on the heterogeneity of selected studies. A total of 6,447 patients were available for the meta-analysis; 2,260 had renal cell carcinoma (RCC) and 4,187, 1,691 non-small cell lung cancers, 599 hepatocellular cancers, 1,066 breast cancers, 165 neuroendocrine tumors, 304 gastrointestinal stromal tumors and 362 soft tissue sarcomas. Diarrhea was the most common GI event. When stratified by tumor type (RCC vs. non-RCC), the difference among the incidences of GI events was significant for diarrhea (p <0.001) and vomiting (p = 0.006), that resulted higher in RCC patients. In RCC patients, sorafenib registered the lower incidence and RR of all grades GI events. The difference was statistically significant for sorafenib versus sunitinib-related all and high-grade events (p <0.001) and for sorafenib versus pazopanib all grades GI events (p <0.001) and high-grade anorexia (p <0.001). Treatment with VEGFR TKIs sorafenib, sunitinib and pazopanib is associated with a significant increase in the risk of GI events in patients with cancer, and frequent clinical monitoring should be emphasized when managing these three and newer VEGFR TKIs.

Original languageEnglish
Pages (from-to)763-773
Number of pages11
JournalInternational Journal of Cancer
Volume135
Issue number4
DOIs
Publication statusPublished - Aug 15 2014

Keywords

  • cancer
  • gastrointestinal adverse events
  • meta-analysis
  • renal cell carcinoma
  • tyrosine kinase inhibitors

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Fingerprint Dive into the research topics of 'Risk of gastrointestinal events with sorafenib, sunitinib and pazopanib in patients with solid tumors: A systematic review and meta-analysis of clinical trials'. Together they form a unique fingerprint.

  • Cite this