Wei-Xiang Qi1, Ai-Na He, Zan Shen, Yang Yao. 1. Department of Oncology, The Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, 200233, China.
Abstract
AIMS: To investigate the overall incidence and risk of hypertension in cancer patients who receive axitinib and compare the differences in incidences between axitinib and the other four approved vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKIs). METHODS: Several databases were searched, including Pubmed, Embase and Cochrane databases. Eligible studies were phase II and III prospective clinical trials of patients with cancer assigned axitinib at a starting dose of 5 mg orally twice daily with data on hypertension available. Overall incidence rates, relative risk (RR), and 95% confidence intervals (CI) were calculated employing fixed or random effects models depending on the heterogeneity of the included trials. RESULTS: A total of 1908 patients from 10 clinical trials were included. The overall incidences of all grade and high grade hypertension in cancer patients were 40.1% (95% CI 30.9, 50.2%) and 13.1% (95% CI 6.7, 24%). The use of axitinib was associated with significantly increased risk of all grade (RR 3.00, 95% CI 1.29, 6.97, P = 0.011) and high grade hypertension (RR 1.71, 95% CI 1.21, 2.43, P = 0.003). The risk of axitinib associated all grade and high grade hypertension in renal cell carcinoma (RCC) was significantly higher than that in non-RCC. Additionally, the risk of hypertension with axitinib was substantially higher than other approved VEGFR-TKIs, while the risk of all grade hypertension with axitinib was similar to pazopanib (RR 1.05; 95% CI 0.95-, 1.17, P = 0.34). CONCLUSIONS: While sharing a similar spectrum of target receptors with other VEGFR-TKIs, axitinib is associated with an unexpectedly high risk of developing hypertension. Close monitoring and appropriate management for hypertension are recommended during the treatment.
AIMS: To investigate the overall incidence and risk of hypertension in cancerpatients who receive axitinib and compare the differences in incidences between axitinib and the other four approved vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKIs). METHODS: Several databases were searched, including Pubmed, Embase and Cochrane databases. Eligible studies were phase II and III prospective clinical trials of patients with cancer assigned axitinib at a starting dose of 5 mg orally twice daily with data on hypertension available. Overall incidence rates, relative risk (RR), and 95% confidence intervals (CI) were calculated employing fixed or random effects models depending on the heterogeneity of the included trials. RESULTS: A total of 1908 patients from 10 clinical trials were included. The overall incidences of all grade and high grade hypertension in cancerpatients were 40.1% (95% CI 30.9, 50.2%) and 13.1% (95% CI 6.7, 24%). The use of axitinib was associated with significantly increased risk of all grade (RR 3.00, 95% CI 1.29, 6.97, P = 0.011) and high grade hypertension (RR 1.71, 95% CI 1.21, 2.43, P = 0.003). The risk of axitinib associated all grade and high grade hypertension in renal cell carcinoma (RCC) was significantly higher than that in non-RCC. Additionally, the risk of hypertension with axitinib was substantially higher than other approved VEGFR-TKIs, while the risk of all grade hypertension with axitinib was similar to pazopanib (RR 1.05; 95% CI 0.95-, 1.17, P = 0.34). CONCLUSIONS: While sharing a similar spectrum of target receptors with other VEGFR-TKIs, axitinib is associated with an unexpectedly high risk of developing hypertension. Close monitoring and appropriate management for hypertension are recommended during the treatment.
Authors: J R Horowitz; A Rivard; R van der Zee; M Hariawala; D D Sheriff; D D Esakof; G M Chaudhry; J F Symes; J M Isner Journal: Arterioscler Thromb Vasc Biol Date: 1997-11 Impact factor: 8.311
Authors: J C Peterson; S Adler; J M Burkart; T Greene; L A Hebert; L G Hunsicker; A J King; S Klahr; S G Massry; J L Seifter Journal: Ann Intern Med Date: 1995-11-15 Impact factor: 25.391
Authors: Kristian Wachtell; Hans Ibsen; Michael H Olsen; Knut Borch-Johnsen; Lars H Lindholm; Carl Erik Mogensen; Björn Dahlöf; Richard B Devereux; Gareth Beevers; Ulf de Faire; Frej Fyhrquist; Stevo Julius; Sverre E Kjeldsen; Krister Kristianson; Ole Lederballe-Pedersen; Markku S Nieminen; Peter M Okin; Per Omvik; Suzanne Oparil; Hans Wedel; Steven M Snapinn; Peter Aurup Journal: Ann Intern Med Date: 2003-12-02 Impact factor: 25.391
Authors: Vivek Narayan; Stephen Keefe; Naomi Haas; Le Wang; Igor Puzanov; Mary Putt; Anna Catino; James Fang; Neeraj Agarwal; David Hyman; Amanda M Smith; Brian S Finkelman; Hari K Narayan; Steven Ewer; Chantal ElAmm; Daniel Lenihan; Bonnie Ky Journal: Clin Cancer Res Date: 2017-02-14 Impact factor: 12.531
Authors: J R Strosberg; M Cives; J Hwang; T Weber; M Nickerson; C E Atreya; A Venook; R K Kelley; T Valone; B Morse; D Coppola; E K Bergsland Journal: Endocr Relat Cancer Date: 2016-04-14 Impact factor: 5.678
Authors: Ole-Petter R Hamnvik; Toni K Choueiri; Alexander Turchin; Rana R McKay; Lipika Goyal; Michael Davis; Marina D Kaymakcalan; Jonathan S Williams Journal: Cancer Date: 2014-09-18 Impact factor: 6.860