title: Pruritus in patients treated with targeted cancer therapies: systematic review and meta-analysis.
abstract: BACKGROUND
  Pruritus has been anecdotally described in association with targeted cancer therapies. The risk of pruritus has not been systematically ascertained.
  
  
  OBJECTIVE
  A systematic review and meta-analysis of the literature was conducted for axitinib, cetuximab, dasatinib, erlotinib, everolimus, gefitinib, imatinib, ipilimumab, lapatinib, nilotinib, panitumumab, pazopanib, rituximab, sorafenib, temsirolimus, tositumomab, vandetanib, and vemurafenib.
  
  
  METHODS
  Databases from PubMed, Web of Science (January 1998 through July 2012), and American Society of Clinical Oncology abstracts (2004 through 2012) were searched. Incidence and relative risk of pruritus were calculated using random- or fixed-effects model.
  
  
  RESULTS
  The incidences of all-grade and high-grade pruritus were 17.4% (95% confidence interval 16.0%-19.0%) and 1.4% (95% confidence interval 1.2%-1.6%), respectively. There was an increased risk of all-grade pruritus (relative risk 2.90 [95% confidence interval 1.76-4.77, P < .001]) and variation among different drugs (P < .001).
  
  
  CONCLUSIONS
  The reporting of pruritus may vary, resulting from concomitant medications, comorbidities, and underlying malignancies. We found a higher incidence of pruritus in patients with solid tumors, concordant with those targeted therapies with the highest pruritus incidences.
  
  
  CONCLUSIONS
  There is a significant risk of developing pruritus in patients receiving targeted therapies. To prevent suboptimal dosing and decreased quality of life, patients should be counseled and treated against this untoward symptom.
authors: Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors: Courtney J
authors: CJ
authors: Ensslin
authors: Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors: Alyx C
authors: AC
authors: Rosen
authors: Division of Medical Oncology, Department of Medicine, State University of New York at Stony Brook, Stony Brook, New York.
authors: Shenhong
authors: S
authors: Wu
authors: Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York. Electronic address: lacoutum@mskcc.org.
authors: Mario E
authors: ME
authors: Lacouture
mesh_terms: D003875:Drug Eruptions / Q000209:etiology*; D006801:Humans; D058990:Molecular Targeted Therapy / Q000009:adverse effects*; D009369:Neoplasms / Q000188:drug therapy*; D011537:Pruritus / Q000139:chemically induced*
keywords: AE; B-lymphocyte antigen cluster of differentiation 20; Bcr-Abl; CD20; CI; CTLA4; EGFR; EGFRIs; HER2; QoL; RR; Raf; T-lymphocyte antigen 4; VEGFR; adverse events; cancer; confidence interval; epidermal growth factor receptor; epidermal growth factor receptor inhibitors; human epidermal growth factor receptor 2; inhibitor; itch; mammalian target of rapamycin; pruritus; quality of life; relative risk; vascular endothelial growth factor receptor
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