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At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
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Supportive Care in Cancer
Published in: Supportive Care in Cancer 9/2016

01-09-2016 | Review Article

Meta-analysis of cardiovascular toxicity risks in cancer patients on selected targeted agents

Authors: C. P. Escalante, Y. C. Chang, K. Liao, T. Rouleau, J. Halm, P. Bossi, S. Bhadriraju, N. Brito-Dellan, S. Sahai, S. W. Yusuf, A. Zalpour, L. S. Elting, Epidemiology Section of the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer, 2013

Published in: Supportive Care in Cancer | Issue 9/2016

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Abstract

Purpose

The purpose was to estimate the risk and severity of cardiovascular toxicities associated with selected targeted agents.

Methods

We searched English-language literature for randomized clinical trials published between January 1, 2000 and November 30, 2013 of targeted cancer therapy drugs approved by the FDA by November 2010. One hundred ten studies were eligible. Using meta-analytic methods, we calculated the relative risks of several cardiovascular toxicities [congestive heart failure (CHF), decreased left ventricular ejection fraction (DLVEF), myocardial infarction (MI), arrhythmia, and hypertension (HTN)], adjusting for sample size using the inverse-variance technique. For each targeted agent and side effect, we calculated the number needed to harm. Results: Regarding CHF, trastuzumab showed significantly greater risk of all-grade and high-grade CHF. There was significant increased risk of all-grade DLVEF with sorafenib, sunitinib, and trastuzumab and high-grade DLVEF with bevacizumab and trastuzumab. Sorafenib was associated with significant increased all-grade risk of MI based on one study. None was associated with high-grade risk of MI or increased risk of arrhythmia. Bevacizumab, sorafenib, and sunitinib had significant increased risk of all-grade and high-grade HTN.

Conclusions

Several of the targeted agents were significantly associated with increased risk of specific cardiovascular toxicities, CHF, DLVEF, and HTN. Several had significant increased risk for high-grade cardiovascular toxicities (CHF, DLVEF, and HTN). Patients receiving such therapy should be closely monitored for these toxicities and early and aggressive treatment should occur. However, clinical experience has demonstrated that some of these toxicities may be reversible and due to secondary effects.
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Metadata
Title
Meta-analysis of cardiovascular toxicity risks in cancer patients on selected targeted agents
Authors
C. P. Escalante
Y. C. Chang
K. Liao
T. Rouleau
J. Halm
P. Bossi
S. Bhadriraju
N. Brito-Dellan
S. Sahai
S. W. Yusuf
A. Zalpour
L. S. Elting
Epidemiology Section of the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer, 2013
Publication date
01-09-2016
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 9/2016
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-016-3310-3

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