title: Risk of Metabolic Complications in Patients with Solid Tumors Treated with mTOR inhibitors: Meta-analysis.
abstract: OBJECTIVE
  Numerous trials have described a wide variation of metabolic complications associated with the mammalian target of rapamycin inhibitors (mTORi). This analysis aimed to report and critically analyze the risks of mTORi-associated metabolic complications.
  
  
  METHODS
  A comprehensive search of all published phase II or III randomized controlled trials were investigated. Outcomes included were adverse effect profiles of hyperglycemia (HGC), hypertriglyceridemia (HTG), and hypercholesterolemia (HCE).
  
  
  RESULTS
  Sixteen phase II/III clinical trials were identified. The overall incidence of all-grade (AG) and high-grade (HG) metabolic complications associated with mTORi were 39.7% and 4.1% respectively. mTORi use was associated with an increased risk of AG (2.97 [2.25-3.92]) and HG HGC (4.08 [2.71-6.14]), AG (2.22 [1.70-2.89]) and HG HTG (1.88 [1.10-3.20]), and AG (2.48 [1.83-3.36]) and HG HCE (4.26 [2.30-7.90]).
  
  
  CONCLUSIONS
  mTORi are associated with a significantly increased risk of AG and HG HGC, HTG, and HCE. Clinicians should be aware of these risks, perform regular monitoring, and consider alternative anti-neoplastic treatments or adjunctive pharmacological intervention if necessary.
authors.affiliation: Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ, U.S.A. Saint George's University School of Medicine, St. George, Grenada, West Indies.
authors.forename: Sungyub
authors.initials: S
authors.lastname: Lew
authors.affiliation: Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ, U.S.A. Department of Surgery, New Jersey Medical School, Rutgers University, Newark, NJ, U.S.A. Saint George's University School of Medicine, St. George, Grenada, West Indies rchamberlain@barnabashealth.org.
authors.forename: Ronald S
authors.initials: RS
authors.lastname: Chamberlain
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D064420:Drug-Related Side Effects and Adverse Reactions / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008659:Metabolic Diseases / Q000139:chemically induced* / Q000209:etiology; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000378:metabolism*; D047428:Protein Kinase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D058570:TOR Serine-Threonine Kinases / Q000037:antagonists & inhibitors*; D055815:Young Adult
chemical_list: D047428:Protein Kinase Inhibitors; C546842:MTOR protein, human; D058570:TOR Serine-Threonine Kinases
keywords: afinitor; everolimus; hypercholesterolemia; hyperglycemia; hypertriglyceridemia; mTOR inhibitor; ridaforolimus; temsirolimus; torisel