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Risk of hypertension in cancer patients treated with sorafenib: an updated systematic review and meta-analysis

Journal of Human Hypertension volume 27, pages 601–611 (2013)Cite this article

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Abstract

Sorafenib, a multi-kinase inhibitor, has been reported to be associated with hypertension (HTN). However, the risk of severe HTN with sorafenib treatment has not been well described. We performed an up-to-date meta-analysis of high-grade HTN in cancer patients treated with sorafenib. Medline databases and the American Society of Clinical Oncology online database of meeting abstracts were searched up to August 2012 for relevant clinical trials. Eligible studies included phase II and III trials of sorafenib in patients with any type of cancer describing events of HTN according to the Common Terminology Criteria for Adverse Events. The summary incidence, relative risk (RR), and 95% confidence intervals (CIs) were calculated. The incidence of sorafenib-associated high-grade (grade 3–4) HTN was 6.0% (95% CI 4.7–7.3) in a total of 4722 patients from 55 trials of sorafenib as a single agent. Sorafenib-treated patients (4878 subjects from 13 randomized trials) had a significantly higher risk of high-grade HTN (RR 3.20 (95% CI 2.19–4.68)). Subgroup analysis revealed a significantly higher RR of high-grade HTN in patients receiving sorafenib as a single agent compared with patients receiving concomitant chemotherapy or immunotherapy (P=0.0076). The incidence of high-grade HTN associated with sorafenib was significantly higher in patients with renal cell carcinoma (RCC) than those with non-RCC cancer (P<0.0001) as well as patients treated with sorafenib for a longer duration than those treated for a shorter duration (P=0.003). The use of sorafenib is associated with a significantly higher risk of high-grade HTN compared with control.

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Acknowledgements

We thank Kamyar Arasteh for statistical analysis support. This study was not funded by any sponsors.

Author contributions: TF designed the research, collected data, analyzed and interpreted data, performed statistical analysis and wrote the manuscript. A. contributed to the collection of data and revision of the manuscript. MDG participated in the elaboration of the research design and made important contributions in revising the manuscript.

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Authors and Affiliations

  1. Department of Internal Medicine, Beth Israel Medical Center, University Hospital and Manhattan Campus for the Albert Einstein College of Medicine, New York, NY, USA

    T Funakoshi

  2. Division of Hematology/Oncology, Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY, USA

    A Latif & M D Galsky

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  1. T Funakoshi
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  2. A Latif
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Correspondence to T Funakoshi.

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MDG has received research funding from Pfizer. The remaining authors declare no competing financial interests.

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Funakoshi, T., Latif, A. & Galsky, M. Risk of hypertension in cancer patients treated with sorafenib: an updated systematic review and meta-analysis. J Hum Hypertens 27, 601–611 (2013). https://doi.org/10.1038/jhh.2013.30

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  • DOI: https://doi.org/10.1038/jhh.2013.30

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