卡博桑提尼布和癌症患者的血栓栓塞:系统性审查,元分析和回顾性研究
Harish Eswaran1, Rohan R Kasthuri2, Pavan K Bendapudi3
1University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States.
卡博桑提尼布是一种VEGFR TKI癌症药物,显著增加了静脉血栓栓塞的风险. 这一元分析强调了在接受治疗的患者中监测这些危险的血栓的重要性.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 抗血管原剂,包括血管内皮生长因子受体 (VEGFR) 氨酸激酶抑制剂 (TKI),对于治疗各种固体瘤至关重要.
- 人们越来越担心这些抗血管原剂与高血栓栓塞事件风险之间的潜在联系.
- 卡博桑提尼布是癌症治疗中经常使用的VEGFR TKI.
研究的目的:
- 系统地审查和元分析随机对照试验 (RCT),评估卡博桑提尼布与血栓塞栓症风险之间的关联.
- 评估与卡博桑提尼布相关的任何血栓塞栓症,特别是静脉血栓塞栓症 (VTE) 和动脉血栓塞栓症 (ATE) 的风险.
- 分析无进展生存期 (PFS) 并根据治疗开始时间差异进行调整.
主要方法:
- 对14项涉及4,204名患者的RCT进行了系统审查和元分析,将卡博赞提尼布与安慰剂或通常护理进行了比较.
- 主要结局:任何血栓栓塞的风险. 二次结果:VTE风险,ATE风险和PFS.
- 进行了无进展生存率调整的分析,以考虑治疗前的时间变化.
主要成果:
- 卡博桑提尼布显著增加了任何血栓栓塞的风险 (RR, 2.41) 特别是静脉血栓塞 (RR, 3.21),但动脉血栓塞的风险没有显著增加 (RR, 1.31).
- 经过调整后的分析证实了卡博桑提尼布与任何血栓栓塞的风险增加有关 (RR, 1.47) 和VTE (RR, 1.92),但没有ATE (RR, 0.76).
- 一项回顾性队列研究报告了VTE率为180/1000患者年,大多数事件发生在cabozantinib治疗的前六个月内.
结论:
- 卡博桑提尼布与癌症患者静脉血栓栓塞的风险显著增加有关.
- 风险增加似乎主要是由静脉事件而不是动脉事件驱动的.
- 在接受卡博桑提尼布治疗的患者中,需要密切监测血栓栓塞事件,特别是VTE.
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