title: Risk of mucocutaneous toxicities in patients with solid tumors treated with everolimus; a systematic review and meta-analysis.
abstract: BACKGROUND
  We performed a systematic review and meta-analysis of mucocutaneous toxicities associated with the use of everolimus in solid tumors.
  
  
  METHODS
  Eligible studies included randomized Phase II and III trials of patients with solid tumors on everolimus; describing events of stomatitis, skin rash, pruritus and mouth ulceration.
  
  
  RESULTS
  Our search strategy yielded 380 potentially relevant citations on everolimus from Pubmed/Medline, CENTRAL Cochrane registry and American Society of Clinical Oncology meeting library. After exclusion of ineligible studies, a total of 10 clinical trials were considered eligible for the meta-analysis, including eight Phase III trials and two Phase II trials. The relative risk of all-grade stomatitis, skin rash, pruritus and mouth ulceration were 3.86(95% CI: 2.23-6.68; p < 0.001); 3.49(95% CI: 2.39-5.08; p < 0.0001); 2.85(95% CI: 2.04-3.97; p = 0.0001); 3.31 (95% CI: 1.46-7.50; p = 0.004); respectively. Exploratory subgroup analysis showed no effect of tumor types or treatment regimen on the relative risk of the relevant adverse events.
  
  
  CONCLUSIONS
  Our meta-analysis has demonstrated that everolimus is associated with a significantly increased risk of all-grade stomatitis, skin rash, and pruritus and mouth ulceration. Clinicians should be aware of these risks and perform early clinical assessment and intervene accordingly.
authors.affiliation: Department of Clinical Oncology, Faculty of Medicine, Ain shams University, Lotfy Elsayed street, Postal code: 11665, Cairo, Egypt.
authors.forename: Omar
authors.initials: O
authors.lastname: Abdel-Rahman
authors.forename: Mona
authors.initials: M
authors.lastname: Fouad
mesh_terms: D000068338:Everolimus; D006801:Humans; D009092:Mucous Membrane / Q000187:drug effects*; D009369:Neoplasms / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D020123:Sirolimus / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012867:Skin / Q000187:drug effects*
chemical_list: D000068338:Everolimus; D020123:Sirolimus
keywords: everolimus; meta-analysis; pruritus; skin rash; stomatitis