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Cancer Chemotherapy and Pharmacology
Published in: Cancer Chemotherapy and Pharmacology 2/2013

01-02-2013 | Original Article

Incidence and risk of hypertension with pazopanib in patients with cancer: a meta-analysis

Authors: Wei-Xiang Qi, Feng Lin, Yuan-jue Sun, Li-Na Tang, Ai-Na He, Yang Yao, Zan Shen

Published in: Cancer Chemotherapy and Pharmacology | Issue 2/2013

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Abstracts

Purposes

To gain a better understanding of the overall incidence and risk of hypertension in cancer patients who receive pazopanib and to compare the differences in incidence among sorafenib, sunitinib, and pazopanib.

Methods

Several databases were searched, including PubMed, Embase, and Cochrane databases. Eligible studies were phase II and III prospective clinical trials of patients with cancer assigned single drug pazopanib 800 mg/day with data on hypertension available. Overall 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.

Results

A total of 1,651 patients with a variety of solid tumors from 13 clinical trials were included for the meta-analysis. The overall incidences of all-grade and high-grade hypertension in cancer patients were 35.9 % (95 % CI 31.5–40.6 %) and 6.5 % (95 % CI 5.2–8.0 %), respectively. The use of pazopanib was associated with an increased risk of developing all-grade (RR 4.97, 95 % CI 3.38–7.30, p < 0.001) and high-grade hypertension (RR 2.87, 95 % CI 1.16–7.12, p = 0.023). Additionally, there was no significant difference in the incidence of all-grade (RR 1.21, 95 % CI 0.96–1.53, p = 0.11) and high-grade hypertension (RR 1.29, 95 % CI 0.80–2.07, p = 0.30) between RCC and non-RCC patients. Interestingly, the risk of all-grade hypertension with pazopanib was substantially higher than sorafenib (RR 1.99; 95 % CI 1.73–2.29, p = 0.00) and sunitinib (RR 2.20; 95 % CI 1.92–2.52, p = 0.00), while the risk of pazopanib-induced high-grade hypertension was similar to sorafenib (RR 0.98; 95 % CI 0.75–1.30, p = 0.90) and sunitinib (RR 0.81; 95 % CI 0.62–1.06, p = 0.12).

Conclusions

The use of pazopanib is associated with a significantly increased risk of developing hypertension. Close monitoring and appropriate managements are recommended during the therapy. Future studies are still needed to investigate the risk reduction and possible use of pazopanib in selected patients.
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Metadata
Title
Incidence and risk of hypertension with pazopanib in patients with cancer: a meta-analysis
Authors
Wei-Xiang Qi
Feng Lin
Yuan-jue Sun
Li-Na Tang
Ai-Na He
Yang Yao
Zan Shen
Publication date
01-02-2013
Publisher
Springer-Verlag
Published in
Cancer Chemotherapy and Pharmacology / Issue 2/2013
Print ISSN: 0344-5704
Electronic ISSN: 1432-0843
DOI
https://doi.org/10.1007/s00280-012-2025-5

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