Treatment-related fatigue with sorafenib, sunitinib and pazopanib in patients with advanced solid tumors

An up-to-date review and meta-analysis of clinical trials

Matteo Santoni, Alessandro Conti, Francesco Massari, Giorgio Arnaldi, Roberto Iacovelli, Mimma Rizzo, Ugo De Giorgi, Laura Trementino, Giuseppe Procopio, Giampaolo Tortora, Stefano Cascinu

Research output: Contribution to journalArticle

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Abstract

Fatigue is the most common symptom associated with cancer and cancer treatment. We performed an up-to-date meta-analysis to determine the incidence and relative risk (RR) of fatigue in patients (pts) with cancer treated with sorafenib (SO), sunitinib (SU) and pazopanib (PZ). PubMed databases were searched for articles published till August 2013. Eligible studies were selected according to PRISMA statement. Summary incidence, RR and 95% confidence intervals were calculated using random-effects or fixed-effects models based on the heterogeneity of selected studies. Fifteen studies were included in our analysis. A total of 6,996 pts was enrolled: 2,260 had renal cell carcinomas (RCC), 1,691 non-small cell lung cancers, 1,290 breast cancers, 823 hepatocellular carcinomas, 362 soft tissue sarcomas, 304 gastrointestinal solid tumors, 165 neuroendocrine tumors and 101 melanomas. When stratified by drug, SO registered lower incidence and RR of all and high-grade fatigue when compared to SU, whereas the difference between SO and PZ was significant only for all-grade fatigue (p <0.001). The difference between SU and PZ was significant for high-grade (p <0.001) but not for all-grade fatigue (p = 0.52). In RCC pts, PZ showed the lower incidence and RR of all and high-grade fatigue. The differences were significant for SU vs. SO (p <0.001), SU vs. PZ (p <0.001) and SO vs. PZ (p <0.001). Treatment with SO, SU and PZ is associated with an increased incidence of fatigue in pts with cancer. Early and appropriate management is required to avoid unnecessary dose reductions and transitory or definitive treatment discontinuations.

Original languageEnglish
Pages (from-to)1-10
Number of pages10
JournalInternational Journal of Cancer
Volume136
Issue number1
DOIs
Publication statusPublished - Jan 1 2015

Fingerprint

Fatigue
Meta-Analysis
Clinical Trials
Neoplasms
Incidence
Therapeutics
Neuroendocrine Tumors
pazopanib
sorafenib
sunitinib
Renal Cell Carcinoma
PubMed
Non-Small Cell Lung Carcinoma
Sarcoma
Hepatocellular Carcinoma
Melanoma
Databases
Confidence Intervals
Breast Neoplasms
Pharmaceutical Preparations

Keywords

  • cancer
  • fatigue
  • meta-analysis
  • pazopanib
  • renal cell carcinoma
  • sorafenib
  • sunitinib
  • tyrosine kinase inhibitors

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Treatment-related fatigue with sorafenib, sunitinib and pazopanib in patients with advanced solid tumors : An up-to-date review and meta-analysis of clinical trials. / Santoni, Matteo; Conti, Alessandro; Massari, Francesco; Arnaldi, Giorgio; Iacovelli, Roberto; Rizzo, Mimma; De Giorgi, Ugo; Trementino, Laura; Procopio, Giuseppe; Tortora, Giampaolo; Cascinu, Stefano.

In: International Journal of Cancer, Vol. 136, No. 1, 01.01.2015, p. 1-10.

Research output: Contribution to journalArticle

Santoni, Matteo ; Conti, Alessandro ; Massari, Francesco ; Arnaldi, Giorgio ; Iacovelli, Roberto ; Rizzo, Mimma ; De Giorgi, Ugo ; Trementino, Laura ; Procopio, Giuseppe ; Tortora, Giampaolo ; Cascinu, Stefano. / Treatment-related fatigue with sorafenib, sunitinib and pazopanib in patients with advanced solid tumors : An up-to-date review and meta-analysis of clinical trials. In: International Journal of Cancer. 2015 ; Vol. 136, No. 1. pp. 1-10.
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