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01.06.2015 | Original Article | Ausgabe 6/2015

Supportive Care in Cancer 6/2015

Tyrosine kinase inhibitors directed against the vascular endothelial growth factor receptor (VEGFR) have distinct cutaneous toxicity profiles: a meta-analysis and review of the literature

Zeitschrift:
Supportive Care in Cancer > Ausgabe 6/2015
Autoren:
Paul R. Massey, Jonathan S. Okman, Julia Wilkerson, Edward W. Cowen
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s00520-014-2520-9) contains supplementary material, which is available to authorized users.

Abstract

Purpose

Inhibition of the vascular endothelial growth factor receptor (VEGFR) with tyrosine kinase inhibitors (TKIs) is associated with cutaneous adverse effects that increase patient morbidity. Our objective was to examine the skin toxicity profile of anti-VEGFR TKIs and determine the changing incidence in clinical trials.

Methods

PubMed was queried for phase II or III trials of anti-VEGFR TKIs between 2000 and 2013 involving ≥50 patients. Adverse events were abstracted, with results presented in both fixed and random effects models. Odds ratios (OR) and 95 % confidence intervals (CIs) were estimated for studies with at least two arms.

Results

Across 82 included studies, all grades rash (OR, 2.68; 95 % CI, 2.45–2.94), hand-foot skin reaction (HFSR) (OR, 2.70; 95 % CI, 2.43–3.00), and pruritus (OR, 1.25; 95 % CI, 1.12–1.39) were associated with anti-VEGFR TKIs. Vandetanib had the highest incidence of rash (41 %), while sorafenib was most commonly associated with HFSR (37 %) and pruritus (14 %). The incidence of HFSR from 2000 to 2013 showed an upward trend (r 2 = 0.042, p = 0.10) and in sunitinib therapy increased significantly (r 2 = 0.237, p = 0.04).

Conclusion

The incidence of HFSR, rash, and pruritus varies considerably by drug. Our data suggest a continued need to address skin toxicities and improve reporting strategies.

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Zusatzmaterial
ESM 1 (PDF 1994 kb)
520_2014_2520_MOESM1_ESM.pdf
Literatur
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