已发表论文

对晚期软组织肉瘤患者使用帕唑帕尼、索拉非尼和舒尼替尼所产生的与治疗相关的不良反应:一项汇总分析

 

Authors Que Y, Liang Y, Zhao JJ, Ding Y, Peng RQ, Guan YX, Zhang X

Received 3 February 2018

Accepted for publication 4 April 2018

Published 19 July 2018 Volume 2018:10 Pages 2141—2150

DOI https://doi.org/10.2147/CMAR.S164535

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Cristina Weinberg

Peer reviewer comments 4

Editor who approved publication: Dr Antonella D'Anneo

Objective: Research efforts have investigated therapies targeting tyrosine kinase signaling pathways. We performed a pooled analysis to determine the frequency of severe adverse effects in patients with soft tissue sarcoma treated with pazopanib, sorafenib and sunitinib.
Materials and methods: We performed a comprehensive search of PubMed, Web of Science, Ovid, the Cochrane Library and Embase databases from the drugs’ inception to May 2017 to identify clinical trials. All-grade and severe adverse events (AEs; grade≥3) were analyzed.
Results: A total of 10 trials published between 2009 and 2016, including 843 patients, were eligible for analysis. We included 424 patients (three studies) who received pazopanib 800 mg daily, 353 patients (five studies) who received sorafenib 400 mg twice daily and 66 patients (two studies) who received sunitinib 37.5 mg daily. The incidence of AEs is different among the three VEGFR-tyrosine kinase inhibitors (TKIs). Pazopanib showed higher incidence of all-grade nausea, diarrhea and hypertension compared with sorafenib and sunitinib. However, patients in the sorafenib group experienced a significantly higher frequency of all-grade rash (26.1%), hand–foot syndrome (33.4%) and mucositis (38.5%). The difference was highly significant for sorafenib vs. pazopanib in the incidence of all-grade rash (odds ratio [OR] 1.649, 95% CI 1.086–2.505, P =0.023), hand–foot syndrome (OR 3.096, 95% CI 1.271–7.544, =0.009) and mucositis (OR 4.562, 95% CI 2.132–9.609, <0.001). Moreover, the frequency of grade ≥3 mucositis was significantly higher in the sunitinib group compared with the pazopanib or sorafenib group (7.6% vs. 1.3%, OR 6.448, 95% CI 1.499–27.731, =0.013).
Conclusion: Statistically significant differences in certain common adverse effects, such as all-grade and severe AEs, were detected among pazopanib, sorafenib and sunitinib in the current study. Early and prompt management is critically needed to avoid unnecessary dose reductions and treatment-related discontinuations.
Keywords: pazopanib, sorafenib, sunitinib, soft tissue sarcoma




Figure 2 Frequency of all-grade toxicity, including nausea (A), hypertension (B)...