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Adverse events risk associated with anti-VEGFR agents in the treatment of advanced nonsmall-cell lung cancer

View Article: PubMed Central - PubMed

ABSTRACT

To perform this meta-analysis, we investigated the risk of the most clinically relevant adverse events related to antivascular endothelial growth factor receptor (VEGFR) agents in advanced nonsmall-cell lung cancer (NSCLC).

A comprehensive literature search for studies published up to October 2015 was performed. Prospective randomized controlled phase II/III clinical trials that comparing therapy with or without anti-VEGFR agents for advanced NSCLC were included for analysis. Summary relative risk (RR) and 95% confidence intervals (CIs) were calculated using random effects or fixed effects according to the heterogeneity among included trials.

A total of 11,701 patients from 18 clinical trials were included for analysis. Pooled RR showed that the use of anti-VEGFR agents significantly increased the risk of developing hypertension (RR 4.71, 95% CI 3.29–6.73, P < 0.001) and fatal adverse events (RR 1.33, 95% CI 1.12–1.58, P = 0.001). No statistically significant differences were found for gastrointestinal (GI) perforation (P = 0.41), arterial or venous thromboembolic events (P = 0.49 and P = 0.16, respectively), or hemorrhagic events (P = 0.81). Sensitive analysis indicated that the significance estimate of pooled RR of fatal adverse event (FAEs) was not significantly influenced by omitting any single study.

The use of anti-VEGFR agents in advanced NSCLC does significantly increase the risk of hypertension and fatal adverse events, but not for arterial or venous thromboembolic events, GI perforation, or hemorrhagic events.

No MeSH data available.


Related in: MedlinePlus

Meta-analysis of fatal adverse events associated with anti-VEGFR agents versus control: “leave-one-out” sensitivity analysis. VEGFR = vascular endothelial growth factor receptor.
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Figure 3: Meta-analysis of fatal adverse events associated with anti-VEGFR agents versus control: “leave-one-out” sensitivity analysis. VEGFR = vascular endothelial growth factor receptor.

Mentions: A total of 289 (4.4%) grade 5 AEs were observed in the anti-VEGFR agent group and 208 (3.5%) in the control group. This confers a pooled RR of developing grade 5 events of 1.33 (95% CI 1.12–1.58, P = 0.001 (Fig. 2F). We also did sensitivity analysis to examine the stability and reliability of pooled RRs by sequential omission of individual studies. The results indicated that the significance estimate of pooled RR of FAEs was not significantly influenced by omitting any single study (Fig. 3).


Adverse events risk associated with anti-VEGFR agents in the treatment of advanced nonsmall-cell lung cancer
Meta-analysis of fatal adverse events associated with anti-VEGFR agents versus control: “leave-one-out” sensitivity analysis. VEGFR = vascular endothelial growth factor receptor.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5134808&req=5

Figure 3: Meta-analysis of fatal adverse events associated with anti-VEGFR agents versus control: “leave-one-out” sensitivity analysis. VEGFR = vascular endothelial growth factor receptor.
Mentions: A total of 289 (4.4%) grade 5 AEs were observed in the anti-VEGFR agent group and 208 (3.5%) in the control group. This confers a pooled RR of developing grade 5 events of 1.33 (95% CI 1.12–1.58, P = 0.001 (Fig. 2F). We also did sensitivity analysis to examine the stability and reliability of pooled RRs by sequential omission of individual studies. The results indicated that the significance estimate of pooled RR of FAEs was not significantly influenced by omitting any single study (Fig. 3).

View Article: PubMed Central - PubMed

ABSTRACT

To perform this meta-analysis, we investigated the risk of the most clinically relevant adverse events related to antivascular endothelial growth factor receptor (VEGFR) agents in advanced nonsmall-cell lung cancer (NSCLC).

A comprehensive literature search for studies published up to October 2015 was performed. Prospective randomized controlled phase II/III clinical trials that comparing therapy with or without anti-VEGFR agents for advanced NSCLC were included for analysis. Summary relative risk (RR) and 95% confidence intervals (CIs) were calculated using random effects or fixed effects according to the heterogeneity among included trials.

A total of 11,701 patients from 18 clinical trials were included for analysis. Pooled RR showed that the use of anti-VEGFR agents significantly increased the risk of developing hypertension (RR 4.71, 95% CI 3.29–6.73, P < 0.001) and fatal adverse events (RR 1.33, 95% CI 1.12–1.58, P = 0.001). No statistically significant differences were found for gastrointestinal (GI) perforation (P = 0.41), arterial or venous thromboembolic events (P = 0.49 and P = 0.16, respectively), or hemorrhagic events (P = 0.81). Sensitive analysis indicated that the significance estimate of pooled RR of fatal adverse event (FAEs) was not significantly influenced by omitting any single study.

The use of anti-VEGFR agents in advanced NSCLC does significantly increase the risk of hypertension and fatal adverse events, but not for arterial or venous thromboembolic events, GI perforation, or hemorrhagic events.

No MeSH data available.


Related in: MedlinePlus