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Neuropathy with vascular endothelial growth factor receptor tyrosine kinase inhibitors: A meta-analysis

Bhaskar Roy1, Avash Das2, Kumar Ashish2

  • 1From the Department of Neurology (B.R., R.J.N., H.S.P.), Division of Neuromuscular Medicine, Yale School of Medicine, New Haven, CT; Department of Molecular Genetics (A.D.), University of Texas Southwestern Medical Center, Dallas; Crozer-Chester Medical Center (K.A.), Upland, PA; Division of Internal Medicine (D.B.), St. Luke Roosevelt Medical Center, Mount Sinai, NY; Division of Cancer Medicine (A.M.), the University of Texas MD Anderson Cancer Center, Houston; Department of Internal Medicine (S.C.), Interfaith Medical Center, Brooklyn, NY; and Treadwell Library (M.E.S., L.L.P.), Massachusetts General Hospital, Boston. bhaskar.roy@yale.edu.

Neurology
|June 7, 2019
PubMed
Abstract

Insights

Vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) increase the risk of peripheral neuropathy in cancer patients. This risk is higher for sensory and high-grade neuropathies.

Area of Science:

  • Oncology
  • Pharmacology
  • Clinical Trials

Background:

  • Peripheral neuropathy is a potential adverse effect of cancer therapies.
  • Vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) are a class of targeted cancer drugs.
  • Understanding the specific risks associated with VEGFR-TKIs is crucial for patient management.

Purpose of the Study:

  • To investigate the association between VEGFR-TKIs and peripheral neuropathy in cancer patients.
  • To quantify the risk of peripheral neuropathy in patients treated with VEGFR-TKIs.

Main Methods:

  • A systematic search of published data up to November 2018 was conducted.
  • Included studies were randomized clinical trials (RCTs) involving cancer patients treated with VEGFR-TKIs.
  • Random-effects meta-analysis was used to estimate the relative risk (RR) of peripheral neuropathy.

Main Results:

  • Thirty RCTs with 12,490 patients were analyzed.
  • VEGFR-TKIs were associated with a significantly higher risk of peripheral neuropathy compared to placebo (RR 1.76).
  • Increased risks were observed for sensory neuropathy, high-grade neuropathy, and high-grade sensory neuropathy with VEGFR-TKIs treatment.

Conclusions:

  • VEGFR-TKIs therapy is linked to an elevated risk of developing neuropathy.
  • The findings highlight the importance of monitoring for neuropathy in cancer patients receiving VEGFR-TKIs.
  • Further research may explore mechanisms and management strategies for VEGFR-TKI-induced neuropathy.

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