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. 2018 Jan 18;32(1):30-38.
doi: 10.7555/JBR.32.20170080.

Safety of axitinib and sorafenib monotherapy for patients with renal cell carcinoma: a meta-analysis

Fei Qin  1 , Hao Yu  1 , Chang-Rong Xu  1 , Hui-Hui Chen  1 , Jian-Ling Bai  1
Affiliations

Safety of axitinib and sorafenib monotherapy for patients with renal cell carcinoma: a meta-analysis

Fei Qin et al. J Biomed Res. .

Abstract

We sought to investigate safety of axitinib or sorafenib in renal cell carcinoma (RCC) patients and compare toxicity of these two vascular endothelial growth factor receptor inhibitors. Databases of PubMed and Embase were searched. We included phase II and III prospective trials, as well as retrospective studies, in which patients diagnosed with RCC were treated with axitinib or sorafenib monotherapy at a starting dose of 5 mg and 400 mg twice daily, respectively. The overall incidence of high grade hypertension, fatigue, gastrointestinal toxicity and hand-foot syndrome, along with their 95% confidence intervals (CI), were calculated using fixed- or random- effects model according to heterogeneity test results. A total of 26 trials, including 4790 patients, were included in our meta-analysis. Among them, 6 arms were related to axitinib and 22 were associated with sorafenib. The incidences of hypertension (24.9% vs. 7.9%), fatigue (8.2% vs. 6.6%), and gastrointestinal toxicity (17.6% vs. 11.3%) were higher in patients receiving axitinib versus those receiving sorafenib, while the incidence of hand-foot syndrome was lower in patients receiving axitinib versus those receiving sorafenib (9.5% vs. 13.3%). In conclusion, axitinib showed noticeably higher risks of toxicity versus sorafenib. Close monitoring and effective measures for adverse events are recommended during therapy.

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Figures

Fig.1
Fig.1
Flowchart of study selection procedure
Fig.2
Fig.2
Incidence of high-grade hypertension to axitinib and sorafenib
Fig.3
Fig.3
Odds ratio of axitinib and sorafenib for high-grade hypertension in two phase III trials
Fig.4
Fig.4
Incidence of high-grade fatigue to axitinib and sorafenib
Fig.5
Fig.5
Incidence of high-grade hand-foot syndrome to axitinib and sorafenib
See this image and copyright information in PMC

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