title: Meta-analysis of the risks of hypertension and QTc prolongation in patients with advanced non-small cell lung cancer who were receiving vandetanib.
abstract: BACKGROUND
  A meta-analysis of published data was conducted to investigate the overall risks of hypertension and QTc prolongation in patients with advanced non-small cell lung cancer (NSCLC) who were receiving vandetanib.
  
  
  METHODS
  A computerized search through electronic databases, including PubMed and Embase (until Dec 2014), was performed to obtain eligible randomized controlled trials (RCTs) that compared hypertension and/or QTc prolongation profile of vandetanib alone or plus chemotherapy with control groups (placebo, single targeted therapy, chemotherapy, or a combination of them) in patients with advanced NSCLC. The outcome measures were the overall risks of hypertension and QTc prolongation. Relative risk (RR) and 95% confidence interval (CI) were calculated and pooled using a random effects model.
  
  
  RESULTS
  A total of nine RCTs, which involved 4813 patients, were enrolled in the present study. A significant increase in risk was observed for all-grade hypertension (RR 5.58; 95% CI 4.16 to 7.48; P < 0.00001) and grade ≥3 hypertension (RR 4.79; 95% CI 2.31 to 9.93; P < 0.0001) in advanced NSCLC patients who were receiving vandetanib compared with the controls. Moreover, vandetanib significantly prolonged all-grade QTc interval (RR 7.90; 95% CI 4.03 to 15.50; P < 0.00001) and grade ≥3 QTc interval (RR 3.12; 95% CI 1.01 to 9.63; P = 0.05).
  
  
  CONCLUSIONS
  Current evidence showed that significant risks in developing hypertension and QTc prolongation exist in advanced NSCLC patients who were receiving vandetanib. Thus, appropriate monitoring and management of these events are recommended.
authors.affiliation: Department of Respiratory Medicine, Chinese PLA Air Force General Hospital, Beijing, 100142, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Liu
authors.forename: Yi
authors.initials: Y
authors.lastname: Liu
authors.forename: Zai-Wen
authors.initials: ZW
authors.lastname: Fan
authors.forename: Jian
authors.initials: J
authors.lastname: Li
authors.forename: Guo-Gang
authors.initials: GG
authors.lastname: Xu
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D006801:Humans; D006973:Hypertension / Q000139:chemically induced* / Q000453:epidemiology; D008133:Long QT Syndrome / Q000139:chemically induced* / Q000453:epidemiology; D008175:Lung Neoplasms / Q000188:drug therapy*; D010880:Piperidines / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D011799:Quinazolines / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012306:Risk
chemical_list: D000970:Antineoplastic Agents; D010880:Piperidines; D011799:Quinazolines; C452423:vandetanib