title: Incidence and risk of hypertension associated with cabozantinib in cancer patients: a systematic review and meta-analysis.
abstract: BACKGROUND
  Cabozantinib (XL184) is an oral inhibitor of multiplereceptor tyrosine kinases including mesenchymal-epithelial transition factor (MET) and vascular endothelial growth factor receptor 2 (VEGFR2). Hypertension is one of its major side effects, but the incidence rate and overall risk has not been systematically studied. We thus conducted this meta-analysis to investigate the overall incidence and risk of developing hypertension in cancer patients treated with cabozantinib.
  
  
  METHODS
  Pubmed, Embase and oncology conference proceedings were searched for relevant studies. Eligible studies were phase II and III prospective clinical trials of cabozantinib in cancer patients with data on hypertension available. A total of 1,514 patients (cabozantinib, 1083; control, 431) with a variety of solid tumors from 8 prospective clinical trials were included for the meta-analysis. The use of cabozantinib was associated with significantly increased risk of developing all grade (RR 5.48; 95%CI, 3.76-7.99; p < 0.001) and high grade (5.09; 95% CI: 2.71-9.54, p < 0.001) hypertension in comparison with controls. Additionally, the risk of high grade hypertension with cabozantinib was substantially higher than other four approved VEGFR-TKIs (sorafenib, sunitinib, vandetanib and pazopanib). Expert commentary: Cancer patients receiving cabozantinib have an increased risk of developing hypertension. Close monitoring and management of hypertension are recommended.
authors.affiliation: a Department of Radiation Oncology , Affiliated Hospital of Hebei University , Baoding , China.
authors.forename: Xi
authors.initials: X
authors.lastname: Zhang
authors.affiliation: b Department of Intervention , Affiliated Hospital of Hebei University , Baoding , China.
authors.forename: Yongjie
authors.initials: Y
authors.lastname: Shao
authors.affiliation: c Department of Medical Oncology , Affiliated Hospital of Hebei University , Baoding , China.
authors.forename: Kunjie
authors.initials: K
authors.lastname: Wang
mesh_terms: D000813:Anilides / Q000009:adverse effects* / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D006801:Humans; D006973:Hypertension / Q000139:chemically induced* / Q000453:epidemiology; D015994:Incidence; D009369:Neoplasms / Q000188:drug therapy*; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D011725:Pyridines / Q000009:adverse effects* / Q000627:therapeutic use; D012306:Risk
chemical_list: D000813:Anilides; D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011725:Pyridines; C558660:cabozantinib
keywords: Cabozantinib; cancer patients; hypertension; meta-analysis