Treatment-related toxicities of apatinib in solid tumors: a meta-analysis

Area of Science:

• Oncology
• Pharmacology
• Clinical Trials

Background:

• Apatinib is a novel small molecule drug targeting vascular endothelial growth factor receptor-2 (VEGFR-2).
• It is under investigation for efficacy across various cancer types.
• This meta-analysis focuses on adverse events associated with apatinib therapy.

Purpose of the Study:

• To quantify the incidence and risk of hypertension, proteinuria, and hand-foot-syndrome (HFS) in cancer patients treated with apatinib.
• To compare the risks of these adverse events against placebo in clinical trials.
• To evaluate the safety profile of apatinib concerning specific adverse events.

Main Methods:

• A meta-analysis was conducted on data from 7 prospective clinical trials (Phase II and III).
• Included patients (n=820) received apatinib for various cancers.
• Incidences and relative risks (RR) with 95% confidence intervals (CI) were calculated using fixed or random effects models.

Main Results:

• The incidences of all-grade hypertension, proteinuria, and HFS were 45.4%, 45.1%, and 35.9%, respectively.
• High-grade incidences were 9.7% for hypertension, 3.7% for proteinuria, and 8.6% for HFS.
• Apatinib significantly increased the risk of all-grade and high-grade hypertension (RR=6.53, RR=7.73) and HFS (RR=11.45, RR=7.23) compared to placebo. The risk for high-grade proteinuria was not significantly increased (RR=2.56).

Conclusions:

• Apatinib is associated with increased risks of all-grade and high-grade hypertension and hand-foot-syndrome (HFS).
• The risk for high-grade proteinuria was not significantly elevated compared to placebo.
• Overall, apatinib is considered generally well-tolerated despite these associated risks.