title: Incidence and risk of hypertension with vandetanib in cancer patients: a systematic review and meta-analysis of clinical trials.
abstract: OBJECTIVE
  To perform a systematic review and meta-analysis of published clinical trials to determine incidence rate and overall risk of hypertension with vandetanib in cancer patients.
  
  
  METHODS
  A comprehensive literature search for studies published up to March 2012 was performed. Summary 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 11 trials with 3154 patients were included for the meta-analysis. The summary incidences of all-grade and high-grade hypertension in patients with cancer were 24.2% [95% confidence interval (CI), 18.1-30.2%] and 6.4% (95% CI, 3.3-9.5%), respectively. Subgroup analysis demonstrated that the pooled incidences of all-grade and high-grade hypertension were 21.8% [95% CI, 15-30.5%] and 7.6% (95% CI, 2.8-18.8%), respectively, among non-small-cell lung cancer (NSCLC) patients, and 32.1% (95% CI: 27.3-37.3%) and 8.8% (5.9%-12.9%), respectively, among MTC patients, and 15.4 (95% CI: 3.2-33.7%) and 3.4% (95% CI: 1%-11.1%) respectively, among non-MTC/NSCLC tumors patients. Furthermore, vandetanib was associated with a significant increased risk of all-grade hypertension (RR 5.1, 95% CI: 3.76-6.92, P = 0.000) and high-grade hypertension (RR 8.06, 95% CI: 3.41-19.04, P = 0.000) in comparison with controls.
  
  
  CONCLUSIONS
  There is a significant risk of developing hypertension in cancer patients receiving vandetanib. Appropriate monitoring and treatment is strongly recommended to prevent cardiovascular complications.
authors.affiliation: Department of Oncology, the Sixth People's Hospital, Shanghai Jiao Tong University, no. 600, Yishan Road, Shanghai, 200233, China.
authors.forename: Wei-xiang
authors.initials: WX
authors.lastname: Qi
authors.forename: Zan
authors.initials: Z
authors.lastname: Shen
authors.forename: Feng
authors.initials: F
authors.lastname: Lin
authors.forename: Yuan-jue
authors.initials: YJ
authors.lastname: Sun
authors.forename: Da-liu
authors.initials: DL
authors.lastname: Min
authors.forename: Li-na
authors.initials: LN
authors.lastname: Tang
authors.forename: Ai-na
authors.initials: AN
authors.lastname: He
authors.forename: Yang
authors.initials: Y
authors.lastname: Yao
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D002986:Clinical Trials as Topic; D006801:Humans; D006973:Hypertension / Q000139:chemically induced* / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D015994:Incidence; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy*; D010880:Piperidines / Q000009:adverse effects*; D017594:Publication Bias; D011799:Quinazolines / Q000009:adverse effects*; D012306:Risk
chemical_list: D000970:Antineoplastic Agents; D010880:Piperidines; D011799:Quinazolines; C452423:vandetanib