Incidence and risk of hypertension with vandetanib in cancer patients: a systematic review and meta-analysis of clinical trials
Version of Record online: 15 MAR 2013
© 2012 The Authors. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society
British Journal of Clinical Pharmacology
Volume 75, Issue 4, pages 919–930, April 2013
How to Cite
Qi, W.-X., Shen, Z., Lin, F., Sun, Y.-j., Min, D.-l., Tang, L.-N., He, A.-N. and Yao, Y. (2013), Incidence and risk of hypertension with vandetanib in cancer patients: a systematic review and meta-analysis of clinical trials. British Journal of Clinical Pharmacology, 75: 919–930. doi: 10.1111/j.1365-2125.2012.04417.x
- Issue online: 15 MAR 2013
- Version of Record online: 15 MAR 2013
- Accepted manuscript online: 9 AUG 2012 11:48PM EST
- Manuscript Accepted: 5 AUG 2012
- Manuscript Received: 7 JUN 2012
- National Natural Science Foundation of China. Grant Numbers: 81001191, 81172105
- Science and Technology Commission of Shanghai. Grant Numbers: 10PJ1408300, 09140902200
To perform a systematic review and meta-analysis of published clinical trials to determine incidence rate and overall risk of hypertension with vandetanib in cancer patients.
A comprehensive literature search for studies published up to March 2012 was performed. Summary incidence rates, relative risk (RR), and 95% confidence intervals (CI) were calculated employing fixed- or random-effects models depending on the heterogeneity of the included trials.
A total of 11 trials with 3154 patients were included for the meta-analysis. The summary incidences of all-grade and high-grade hypertension in patients with cancer were 24.2% [95% confidence interval (CI), 18.1–30.2%] and 6.4% (95% CI, 3.3–9.5%), respectively. Subgroup analysis demonstrated that the pooled incidences of all-grade and high-grade hypertension were 21.8% [95% CI, 15–30.5%] and 7.6% (95% CI, 2.8–18.8%), respectively, among non-small-cell lung cancer (NSCLC) patients, and 32.1% (95% CI: 27.3–37.3%) and 8.8% (5.9%–12.9%), respectively, among MTC patients, and 15.4 (95% CI: 3.2–33.7%) and 3.4% (95% CI: 1%–11.1%) respectively, among non-MTC/NSCLC tumors patients. Furthermore, vandetanib was associated with a significant increased risk of all-grade hypertension (RR 5.1, 95% CI: 3.76–6.92, P = 0.000) and high-grade hypertension (RR 8.06, 95% CI: 3.41–19.04, P = 0.000) in comparison with controls.
There is a significant risk of developing hypertension in cancer patients receiving vandetanib. Appropriate monitoring and treatment is strongly recommended to prevent cardiovascular complications.