Dysphonia induced by anti-angiogenic compounds

Area of Science:

• Oncology
• Pharmacology

Background:

• Angiogenesis inhibitors are increasingly used for various cancers, offering significant patient benefits.
• While effective, these therapies present diverse side effects, with dysphonia often overlooked.

Purpose of the Study:

• To analyze the frequency of dysphonia as a complication of anti-angiogenic drug treatment.
• To review the incidence of voice changes in clinical studies of approved anti-angiogenic agents.

Main Methods:

• Systematic review of 88 studies on anti-angiogenic drugs (bevacizumab, aflibercept, sunitinib, sorafenib, pazopanib, axitinib, regorafenib).
• Analysis focused on Phase I, II, and III clinical trials reported in ClinicalTrials.gov up to March 2013.
• Inclusion of studies reporting dysphonia or voice changes as a side effect.

Main Results:

• Dysphonia was reported in nearly all studies involving anti-angiogenic treatment arms.
• The incidence of voice changes suggests it is a frequent complication of these therapies.
• Specific drugs like axitinib, aflibercept, and regorafenib showed notable associations with dysphonia.

Conclusions:

• Dysphonia is a common, though often overlooked, side effect of anti-angiogenic cancer therapies.
• The mechanism may involve alterations in the larynx and vocal fold vibration due to angiogenesis inhibition.
• Increased physician awareness is needed to manage this quality-of-life impacting side effect.