title: Risk of elevated transaminases in non-small cell lung cancer (NSCLC) patients treated with erlotinib, gefitinib and afatinib: a meta-analysis.
abstract: This meta-analysis has been conducted to determine the risk of elevated transaminases associated with the use of erlotinib, gefitinib and afatinib in patients with non-small cell lung cancer (NSCLC). Studies eligible for our analysis included randomized phase II and III trials of patients with NSCLC on the three agents which describe events of elevated alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Initial database search revealed 300 relevant citations. After excluding non-eligible studies, 24 trials were considered eligible for the analysis. The relative risk (RR) of all-grade elevated ALT and AST was 1.82 (95% CI: 1.42-2.34; p < 0.00001) and 2.09 (95% CI: 1.54-2.83; p < 0.00001) respectively; while for high-grade elevated ALT and AST, it was 9.23 (95% CI: 5.06-16.85; p < 0.00001) and 1.78 (95% CI: 0.5-6.26; p = 0.37), respectively. Our meta-analysis has shown that there is an overall elevated risk of elevated transaminases with the use of these agents.
authors.affiliation: a Clinical Oncology Department, Faculty of Medicine , Ain Shams University , Cairo , Egypt.
authors.forename: Omar
authors.initials: O
authors.lastname: Abdel-Rahman
authors.affiliation: b Clinical Oncology Department , Nasser Institute , Cairo , Egypt.
authors.forename: Hoda
authors.initials: H
authors.lastname: Ahmed
authors.affiliation: a Clinical Oncology Department, Faculty of Medicine , Ain Shams University , Cairo , Egypt.
authors.forename: Hesham
authors.initials: H
authors.lastname: ElHalawani
mesh_terms: D000077716:Afatinib; D000410:Alanine Transaminase / Q000097:blood*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001219:Aspartate Aminotransferases / Q000097:blood*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy; D000069347:Erlotinib Hydrochloride / Q000627:therapeutic use*; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy; D011799:Quinazolines / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D011799:Quinazolines; D000077716:Afatinib; D000069347:Erlotinib Hydrochloride; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000077156:Gefitinib
keywords: ALT; AST; Erlotinib; afatinib; gefitinib