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Updated: Nov 26, 2025

A Simple Bioassay for the Evaluation of Vascular Endothelial Growth Factors
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A Simple Bioassay for the Evaluation of Vascular Endothelial Growth Factors

Published on: March 15, 2016

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Bleeding with vascular endothelial growth factor tyrosine kinase inhibitor: A network meta-analysis

Avash Das1, Somnath Mahapatra2, Dhrubajyoti Bandyopadhyay3

  • 1Department of Molecular Genetics, University of Texas Southwestern Medical Center, Dallas, TX, USA.

Critical Reviews in Oncology/Hematology
|December 14, 2020
PubMed
Abstract

Insights

Vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) increase bleeding risk in cancer patients. Sunitinib and Regorafenib showed the highest risk of hemorrhagic events compared to placebo.

Area of Science:

  • Oncology
  • Pharmacology
  • Clinical Trials

Background:

  • Vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) are a primary treatment for various cancers.
  • Understanding the bleeding risk associated with VEGFR-TKIs is crucial for patient safety.

Purpose of the Study:

  • To conduct a network meta-analysis comparing the risk of bleeding events among different VEGFR-TKIs.
  • To identify specific VEGFR-TKIs with a higher propensity for causing hemorrhagic events.

Main Methods:

  • A systematic search of published data up to November 2018 was conducted.
  • Eleven VEGFR-TKIs were analyzed for their side-effect profile regarding bleeding.
  • A random-effects model network meta-analysis was used to estimate Odds Ratios (OR) and 95% Confidence Intervals (CI) compared to placebo.

Main Results:

  • Fifty randomized clinical trials (RCTs) with 16,753 patients were included.
  • VEGFR-TKIs demonstrated an increased incidence of all-grade hemorrhagic events compared to control (OR = 1.79; 95% CI 1.50-2.13).
  • Sunitinib (OR = 3.31) and Regorafenib (OR = 2.92) were associated with a significantly higher risk of bleeding events compared to placebo.

Conclusions:

  • VEGFR-TKIs are linked to an elevated risk of bleeding incidence in cancer patients.
  • Sunitinib and Regorafenib specifically show a pronounced association with increased hemorrhagic events.
  • The findings highlight the importance of monitoring for bleeding complications in patients treated with these targeted therapies.
Keywords:
BleedingClinical trials systematic review/network meta-analysisVEGFR-TKIs

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