title: Risk of hematologic toxicities in patients with solid tumors treated with everolimus: a systematic review and meta-analysis.
abstract: We performed a systematic review and meta-analysis of hematologic toxicities associated with everolimus, an oral mammalian target of rapamycin (mTOR) inhibitor. Eligible studies included phase II and III trials of patients with solid tumors on 10mg of everolimus daily describing events of neutropenia, thrombocytopenia, anemia or lymphopenia. The incidence of everolimus-associated all-grade and high-grade (Grade 3-4) hematologic toxicities were, respectively: neutropenia: 21.7% and 3.6%; thrombocytopenia: 36.0% and 4.7%; anemia: 61.2% and 8.4% and lymphopenia: 40.9% and 14.9%. Everolimus was associated with an increased risk of all-grade neutropenia (RR=2.24, [95% CI 1.51-3.32]), all-grade (RR=9.19, [95% CI 4.51-18.70]) and high-grade (RR=7.46, [95% CI 2.58-21.61]) thrombocytopenia, all-grade (RR=1.58, [95% CI 1.25-1.99]) and high-grade (RR=3.92, [95% CI 1.46-10.52]) anemia and all-grade (RR=1.72, [95% CI 1.50-1.97]) and high-grade (RR=2.70, [95% CI 1.86-3.93]) lymphopenia.
authors.affiliation: Department of Medicine, Beth Israel Medical Center, University Hospital and Manhattan Campus for the Albert Einstein College of Medicine, New York, United States. Electronic address: tfunakoshi@chpnet.org.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Funakoshi
authors.forename: Asma
authors.initials: A
authors.lastname: Latif
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Galsky
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000068338:Everolimus; D006402:Hematologic Diseases / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy; D016017:Odds Ratio; D017594:Publication Bias; D012306:Risk; D020123:Sirolimus / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D000068338:Everolimus; D020123:Sirolimus
keywords: Anemia; Everolimus; Hematologic toxicities; Lymphopenia; Meta-analysis; Neutropenia; Thrombocytopenia