Xuehui Jiang1,2, Fangfang Xiong3, Qun Fu1,2, Hongwei Peng2, Yan Jing4, Kaisaner Rexiti1,2, Xiaohua Wei5, Song Tao6. 1. School of Pharmacy, Nanchang University, Nanchang, China. 2. Department of Pharmacy, the First Affiliated Hospital of Nanchang University, Nanchang, China. 3. School of Pharmacy, Fujian Medical University, Fuzhou, China. 4. Department of Pharmacy, Linyi Central Hospital, Linyi, China. 5. Department of Pharmacy, the First Affiliated Hospital of Nanchang University, Nanchang, China. wxh-hello@163.com. 6. Department of Pharmacy, the First Affiliated Hospital of Nanchang University, Nanchang, China. 1083032243@qq.com.
Abstract
PURPOSE: Sunitinib offers a significant survival benefit to patients with imatinib-resistant gastrointestinal stromal tumors (GIST). However, the incidence and risk of sunitinib-induced hematologic toxicities in such a population are often overlooked and have not been well characterized. This meta-analysis was performed to assess the summary incidence and risk of hematologic toxicities secondary to sunitinib in patients with GIST. METHODS: Searches were performed in PubMed, Embase, Cochrane Library, and Web of Science as well as ClinicalTrials.gov to identify relevant studies up to April 2022. Studies with adequate safety profile, including anemia, neutropenia, and thrombocytopenia, were included to calculate the pooled incidence, relative risk (RR), and corresponding 95% confidence intervals (CIs). This study was registered with PROSPERO under number CRD42022328202. RESULTS: A total of 2593 patients from 13 studies were included in the present meta-analysis. For patients with GIST assigned to sunitinib, the overall incidences of all-grade anemia, neutropenia, and thrombocytopenia were 26.2% (95% CI, 14.9-39.4%), 41.8% (95% CI, 29.0-55.1%), and 36.4% (95% CI, 22.8-51.1%), respectively. Regarding high-grade (grades 3 and 4) events, there were 4.7% (95% CI, 3.8-5.6%) for anemia, 9.3% (95% CI, 5.6-13.7%) for neutropenia and 5.0% (95% CI, 2.9-7.3%) for thrombocytopenia. Compared to placebo arms, sunitinib was related to an increased risk of high-grade neutropenia with an RR of 10.39 (95% CI, 1.53-70.72; p = 0.017). CONCLUSIONS: Sunitinib carries a relatively high incidence of hematologic toxicities and a substantial increased risk of high-grade neutropenia in patients with GIST. Appropriate prevention and management seem to be inevitable.
PURPOSE: Sunitinib offers a significant survival benefit to patients with imatinib-resistant gastrointestinal stromal tumors (GIST). However, the incidence and risk of sunitinib-induced hematologic toxicities in such a population are often overlooked and have not been well characterized. This meta-analysis was performed to assess the summary incidence and risk of hematologic toxicities secondary to sunitinib in patients with GIST. METHODS: Searches were performed in PubMed, Embase, Cochrane Library, and Web of Science as well as ClinicalTrials.gov to identify relevant studies up to April 2022. Studies with adequate safety profile, including anemia, neutropenia, and thrombocytopenia, were included to calculate the pooled incidence, relative risk (RR), and corresponding 95% confidence intervals (CIs). This study was registered with PROSPERO under number CRD42022328202. RESULTS: A total of 2593 patients from 13 studies were included in the present meta-analysis. For patients with GIST assigned to sunitinib, the overall incidences of all-grade anemia, neutropenia, and thrombocytopenia were 26.2% (95% CI, 14.9-39.4%), 41.8% (95% CI, 29.0-55.1%), and 36.4% (95% CI, 22.8-51.1%), respectively. Regarding high-grade (grades 3 and 4) events, there were 4.7% (95% CI, 3.8-5.6%) for anemia, 9.3% (95% CI, 5.6-13.7%) for neutropenia and 5.0% (95% CI, 2.9-7.3%) for thrombocytopenia. Compared to placebo arms, sunitinib was related to an increased risk of high-grade neutropenia with an RR of 10.39 (95% CI, 1.53-70.72; p = 0.017). CONCLUSIONS: Sunitinib carries a relatively high incidence of hematologic toxicities and a substantial increased risk of high-grade neutropenia in patients with GIST. Appropriate prevention and management seem to be inevitable.
Authors: Peter Reichardt; Yoon-Koo Kang; Piotr Rutkowski; Jochen Schuette; Lee S Rosen; Beatrice Seddon; Suayib Yalcin; Hans Gelderblom; Charles C Williams; Elena Fumagalli; Guido Biasco; Herbert I Hurwitz; Pamela E Kaiser; Kolette Fly; Ewa Matczak; Liang Chen; Maria José Lechuga; George D Demetri Journal: Cancer Date: 2015-01-13 Impact factor: 6.860
Authors: S George; J Y Blay; P G Casali; A Le Cesne; P Stephenson; S E Deprimo; C S Harmon; C N J Law; J A Morgan; I Ray-Coquard; V Tassell; D P Cohen; G D Demetri Journal: Eur J Cancer Date: 2009-03-11 Impact factor: 9.162
Authors: Ezzeldin M Ibrahim; Ghieth A Kazkaz; Khaled M Abouelkhair; Ali M Bayer; Osama A Elmasri Journal: Int J Clin Oncol Date: 2012-11-21 Impact factor: 3.402
Authors: P G Casali; J Y Blay; N Abecassis; J Bajpai; S Bauer; R Biagini; S Bielack; S Bonvalot; I Boukovinas; J V M G Bovee; K Boye; T Brodowicz; A Buonadonna; E De Álava; A P Dei Tos; X G Del Muro; A Dufresne; M Eriksson; A Fedenko; V Ferraresi; A Ferrari; A M Frezza; S Gasperoni; H Gelderblom; F Gouin; G Grignani; R Haas; A B Hassan; N Hindi; P Hohenberger; H Joensuu; R L Jones; C Jungels; P Jutte; B Kasper; A Kawai; K Kopeckova; D A Krákorová; A Le Cesne; F Le Grange; E Legius; A Leithner; A Lopez-Pousa; J Martin-Broto; O Merimsky; C Messiou; A B Miah; O Mir; M Montemurro; C Morosi; E Palmerini; M A Pantaleo; R Piana; S Piperno-Neumann; P Reichardt; P Rutkowski; A A Safwat; C Sangalli; M Sbaraglia; S Scheipl; P Schöffski; S Sleijfer; D Strauss; S J Strauss; K Sundby Hall; A Trama; M Unk; M A J van de Sande; W T A van der Graaf; W J van Houdt; T Frebourg; A Gronchi; S Stacchiotti Journal: Ann Oncol Date: 2021-09-21 Impact factor: 32.976
Authors: A Adenis; J-Y Blay; B Bui-Nguyen; O Bouché; F Bertucci; N Isambert; E Bompas; L Chaigneau; J Domont; I Ray-Coquard; A Blésius; B A Van Tine; V R Bulusu; P Dubreuil; C D Mansfield; Y Acin; A Moussy; O Hermine; A Le Cesne Journal: Ann Oncol Date: 2014-07-25 Impact factor: 32.976