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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Onco+Targets+Ther
2015 ; 8
(ä): 2361-74
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Increased risk of severe infections in cancer patients treated with vascular
endothelial growth factor receptor tyrosine kinase inhibitors: a meta-analysis
#MMPMID26355897
Ma Q
; Gu LY
; Ren YY
; Zeng LL
; Gong T
; Zhong DS
Onco Targets Ther
2015[]; 8
(ä): 2361-74
PMID26355897
show ga
BACKGROUND: Vascular endothelial growth factor receptor tyrosine kinase
inhibitors (VEGFR-TKIs) have been widely used in a variety of solid malignancies.
Concerns have arisen regarding the risk of severe infections (?grade 3) with use
of these drugs, but the contribution of VEGFR-TKIs to infections is still
unknown. METHODS: The databases of PubMed and abstracts presented at oncology
conferences' proceedings were searched for relevant studies from January 2000 to
December 2014. Summary incidences, Peto odds ratio (Peto OR), and 95% confidence
intervals (CIs) were calculated by using either random-effects or fixed-effects
models according to the heterogeneity of included studies. RESULTS: A total of
16,488 patients from 27 randomized controlled trials were included. The risk of
developing severe (Peto OR 1.69, 95% CI: 1.45-1.96, P<0.001) and fatal infections
(Peto OR 1.78, 95% CI: 1.13-2.81, P=0.013) was significantly increased in
patients treated with VEGFR-TKIs when compared to controls. Exploratory subgroup
analysis showed no effect of tumor types, phase of trials, or agent used on the
Peto OR of severe infections. When stratified according to specific infectious
events, the risks of high-grade febrile neutropenia, pneumonia, fever, and sepsis
were increased compared with controls, with Peto ORs of 1.57 (95% CI: 1.30-1.88,
P<0.001), 1.79 (95% CI: 1.29-2.49, P<0.001), 5.35 (95% CI: 1.47-19.51, P=0.011),
and 3.68 (95% CI: 1.51-8.99, P=0.004), respectively. Additionally, VEGFR-TKIs
significantly increased the risk of fatal sepsis (OR 3.66, 95% CI: 1.47-9.13,
P=0.005) but not fatal pneumonia (OR 1.34, 95% CI: 0.80-2.25, P=0.26).
CONCLUSION: The use of VEGFR-TKIs significantly increases the risk of developing
severe and fatal infectious events in cancer patients. A close monitoring for any
signs of infections is recommended for patients treated with VEGFR-TKIs.