Adverse events risk associated with anti-VEGFR agents in the treatment of advanced nonsmall-cell lung cancer: A meta-analysis.

Abstract

To perform this meta-analysis, we investigated the risk of the most clinically relevant adverse events related to antivascular endothelial growth factor receptor (VEGFR) agents in advanced nonsmall-cell lung cancer (NSCLC).A comprehensive literature search for studies published up to October 2015 was performed. Prospective randomized controlled phase II/III clinical trials that comparing therapy with or without anti-VEGFR agents for advanced NSCLC were included for analysis. Summary relative risk (RR) and 95% confidence intervals (CIs) were calculated using random effects or fixed effects according to the heterogeneity among included trials.A total of 11,701 patients from 18 clinical trials were included for analysis. Pooled RR showed that the use of anti-VEGFR agents significantly increased the risk of developing hypertension (RR 4.71, 95% CI 3.29-6.73, P < 0.001) and fatal adverse events (RR 1.33, 95% CI 1.12-1.58, P = 0.001). No statistically significant differences were found for gastrointestinal (GI) perforation (P = 0.41), arterial or venous thromboembolic events (P = 0.49 and P = 0.16, respectively), or hemorrhagic events (P = 0.81). Sensitive analysis indicated that the significance estimate of pooled RR of fatal adverse event (FAEs) was not significantly influenced by omitting any single study.The use of anti-VEGFR agents in advanced NSCLC does significantly increase the risk of hypertension and fatal adverse events, but not for arterial or venous thromboembolic events, GI perforation, or hemorrhagic events.