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. 2018 Feb 26;10(41):4205-4212.
doi: 10.18632/oncotarget.24599. eCollection 2019 Jun 25.

Risk of venous and arterial thromboembolic events associated with tyrosine kinase inhibitors in advanced thyroid cancer: a meta-analysis and systematic review

Yang Bai #  1 , Jing-Yan Li #  2 , Jie Li  1 , Bo Zhang  1 , Yong-Hong Liu  1 , Bu-Yong Zhang  1 , Jian Jing  1
Affiliations

Risk of venous and arterial thromboembolic events associated with tyrosine kinase inhibitors in advanced thyroid cancer: a meta-analysis and systematic review

Yang Bai et al. Oncotarget. .

Abstract

Aims: To assess the incidence and risk of arterial and venous thromboembolic events (ATEs and VTEs) associated with tyrosine kinase inhibitors (TKIs) in advanced thyroid cancer patients. Materials and Methods: We comprehensively searched EMBASE, Pubmed, and Cochrane Library for relevant trials. Prospective clinical trials evaluating the role of TKIs alone in advanced thyroid cancer patients were included for analysis. Data on high-grade VTEs and ATEs were extracted. The pooled incidence, Peto odds ratio (Peto OR), and 95% confidence intervals (CIs) were pooled according to the heterogeneity of included trials. Results: A total of 1,781 patients from 12 trials, including four randomized controlled trials and eight phase II single arm trials, were included for analysis. Our results showed that the overall incidence of high-grade ATEs and VTEs associated with TKIs were 1.4% and 3.3%, and TKIs treatment in advanced TCs patients significantly increased the risk of developing high-grade ATEs (Peto OR 4.72, 95% CI: 1.18-18.95, p = 0.029), but not for high-grade VTEs (Peto OR 1.36, 95% CI: 0.51-3.64, p = 0.54) when compared to placebo. The most common specific causes of ATEs were myocardial infarction (28.6%) and ischemic cerebrovascular events (21.4%), respectively. Conclusions: TKIs treatment in advanced thyroid cancer significantly increases the risk of developing high-grade ATEs but not for VTEs. Clinicians should be cautious about the risk of severe ATEs associated with TKIs to maximize the benefits and minimize the toxicities.

Keywords: arterial thromboembolic events; meta-analysis; toxicity; tyrosine kinase inhibitors; venous thromboembolic events.

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Conflict of interest statement

CONFLICTS OF INTEREST All authors declare that they have no potential conflicts of interests.

Figures

Figure 1
Figure 1. Studies eligible for inclusion in the meta-analysis.
Figure 2
Figure 2. Overall incidences of ATEs and VTEs associated with TKIs in TCs patients.
Figure 3
Figure 3. Meta-analysis of ATEs/VTEs associated with TKIs versus placebo in TCs patients.
See this image and copyright information in PMC

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