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Risk of Metabolic Complications in Patients with Solid Tumors Treated with mTOR inhibitors: Meta-analysis

Sungyub Lew1, Ronald S Chamberlain2

  • 1Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ, U.S.A. Saint George's University School of Medicine, St. George, Grenada, West Indies.

Anticancer Research
|April 13, 2016
PubMed
Abstract

Insights

Mammalian target of rapamycin inhibitors (mTORi) increase the risk of metabolic complications like hyperglycemia, hypertriglyceridemia, and hypercholesterolemia. Regular monitoring and potential treatment adjustments are crucial for patients on mTORi therapy.

Area of Science:

  • Oncology
  • Pharmacology
  • Metabolic Medicine

Background:

  • Mammalian target of rapamycin inhibitors (mTORi) are widely used in cancer treatment.
  • Metabolic complications are frequently observed with mTORi therapy.
  • Variability in metabolic adverse events necessitates a clear risk assessment.

Purpose of the Study:

  • To systematically review and analyze the incidence and risk of metabolic complications associated with mTOR inhibitors.
  • To quantify the risk of hyperglycemia, hypertriglyceridemia, and hypercholesterolemia in patients receiving mTORi.

Main Methods:

  • A comprehensive literature search of Phase II and III randomized controlled trials.
  • Inclusion criteria focused on studies reporting adverse effect profiles.
  • Outcomes assessed included hyperglycemia (HGC), hypertriglyceridemia (HTG), and hypercholesterolemia (HCE).

Main Results:

  • Sixteen trials involving mTORi were analyzed, revealing an overall incidence of metabolic complications at 39.7% (all-grade) and 4.1% (high-grade).
  • mTORi use significantly increased the risk of all-grade and high-grade hyperglycemia (OR 2.97 and 4.08, respectively).
  • Increased risks were also observed for all-grade and high-grade hypertriglyceridemia (OR 2.22 and 1.88) and hypercholesterolemia (OR 2.48 and 4.26).

Conclusions:

  • mTOR inhibitors are associated with a significant increase in the risk of hyperglycemia, hypertriglyceridemia, and hypercholesterolemia.
  • Clinicians must be vigilant for these metabolic adverse events.
  • Proactive patient monitoring and consideration of alternative treatments or supportive therapies are recommended.
Keywords:
afinitoreverolimushypercholesterolemiahyperglycemiahypertriglyceridemiamTOR inhibitorridaforolimustemsirolimustorisel

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