title: Venous thromboembolic events with vascular endothelial growth factor receptor tyrosine kinase inhibitors: a systematic review and meta-analysis of randomized clinical trials.
abstract: A trial-level meta-analysis was conducted to determine the relative risk (RR) of venous thromboembolic events (VTEs) associated with approved vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKI). Eligible studies included randomized phase 2 and 3 trials comparing arms with and without a Food and Drug Administration-approved VEGFR TKI (sunitinib, sorafenib, pazopanib, vandetanib, and axitinib). Statistical analyses calculated the RR and 95% confidence intervals (CI), using random-effects or fixed-effects models based on heterogeneity. A total of 7441 patients from 9 phase III trials and 8 phase II trials were selected. The RR of all grade and high-grade VTEs for the TKI vs. no TKI arms was 1.10 (95% CI 0.73-1.66, p=0.64) and 0.85 (95% CI: 0.58-1.25, p=0.41), respectively. No difference in risk was found based on tumor type, age and trial design. The majority of trials exhibited high quality per Jadad scoring and no heterogeneity or publication bias was found.
authors: Department of Medicine, Section of Medical Oncology, University of Alabama at Birmingham (UAB), AL, USA.
authors: Guru
authors: G
authors: Sonpavde
authors: Youjin
authors: Y
authors: Je
authors: Fabio
authors: F
authors: Schutz
authors: Matthew D
authors: MD
authors: Galsky
authors: Ravikumar
authors: R
authors: Paluri
authors: Jonathan E
authors: JE
authors: Rosenberg
authors: Joaquim
authors: J
authors: Bellmunt
authors: Toni K
authors: TK
authors: Choueiri
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy; D047428:Protein Kinase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D017594:Publication Bias; D016032:Randomized Controlled Trials as Topic; D040262:Receptors, Vascular Endothelial Growth Factor / Q000037:antagonists & inhibitors* / Q000378:metabolism; D012306:Risk; D054556:Venous Thromboembolism / Q000139:chemically induced* / Q000378:metabolism
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D040262:Receptors, Vascular Endothelial Growth Factor