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Risk of venous thromboembolic events associated with VEGFR-TKIs: a systematic review and meta-analysis

Wei-Xiang Qi1, Da-Liu Min, Zan Shen

  • 1Department of Oncology, The Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai 200233, China.

International Journal of Cancer
|December 11, 2012
PubMed

Insights

Vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKIs) do not significantly increase the risk of venous thromboembolism (VTE) in cancer patients. VTE risk is primarily influenced by cancer type, patient factors, and other treatments.

Area of Science:

  • Oncology
  • Pharmacology
  • Clinical Trials

Background:

  • Vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKIs) are utilized in advanced cancers.
  • Concerns exist regarding the potential for VEGFR-TKIs to increase venous thromboembolism (VTE) risk.
  • The precise contribution of VEGFR-TKIs to VTE development remains unclear.

Purpose of the Study:

  • To determine the incidence and relative risk (RR) of VTE events associated with VEGFR-TKIs.
  • To evaluate the safety profile of specific VEGFR-TKIs regarding VTE.
  • To inform clinical decision-making for oncologists using VEGFR-TKIs.

Main Methods:

  • A meta-analysis of Phase II and III prospective clinical trials.
  • Inclusion of trials evaluating FDA-approved VEGFR-TKIs (pazopanib, sunitinib, sorafenib, vandetanib).
  • Calculation of overall incidence rates and RR with 95% confidence intervals (CI) using fixed- or random-effects models.

Main Results:

  • 14 studies with 4,430 patients were analyzed.
  • The overall incidence of VTEs related to VEGFR-TKIs was 3% (95% CI: 1.7-5.1%).
  • No statistically significant increase in VTE risk was observed for VEGFR-TKIs compared to controls (RR 0.912, 95% CI: 0.617-1.348). Subgroup analyses by drug or tumor type also showed no significant increase.

Conclusions:

  • VEGFR-TKIs do not significantly elevate the risk of VTE in cancer patients.
  • VTE risk in cancer patients is predominantly driven by tumor type, host factors, and concomitant therapies.
  • These findings support the use of VEGFR-TKIs while emphasizing the importance of considering other risk factors for VTE.

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