Fatigue with vascular endothelial growth factor receptor tyrosine kinase inhibitors and mammalian target of rapamycin inhibitors in patients with renal cell carcinoma (RCC) and other malignancies: A meta-analysis of randomized clinical trials

Ghatalia, Pooja; Je, Youjin; Nguyen, Paul L.; Trinh, Quoc‐Dien; Choueiri, Toni K.; Sonpavde, Guru

doi:10.1016/j.critrevonc.2015.03.006

Cited by 8 publications

(3 citation statements)

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“…Renal and lung cancer was associated with high physical fatigue, too. This is possibly caused by tyrosine kinase inhibitors (TKIs) used for therapy of renal cell carcinoma and non‐small cell lung cancer as fatigue has been shown to be a major side effect of several TKIs 22‐24 …”

Section: Discussionmentioning

confidence: 99%

“…This is possibly caused by tyrosine kinase inhibitors (TKIs) used for therapy of renal cell carcinoma and non-small cell lung cancer as fatigue has been shown to be a major side effect of several TKIs. [22][23][24] Furthermore, after adjusting for the different treatment modalities and patient characteristics, physical fatigue levels were significantly higher among endometrial compared to breast cancer patients. Although the difference failed statistical significance after adjusting for multiple testing (P = .17), it might be worth considering that fatigue in endometrial cancer has been found to be associated with menopausal symptoms, which are a common consequence of the surgical procedures for this type of cancer that result in estrogen deficiency.…”

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confidence: 95%

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Prevalence and severity of long‐term physical, emotional, and cognitive fatigue across 15 different cancer entities

et al. 2020

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Background Fatigue prevalence and severity have been assessed in a variety of studies, yet, not in a standardized way, and predominantly in breast cancer patients. Systematic, comparative investigations across a broad range of cancer entities are lacking. Methods The FiX study systematically enrolled 2244 cancer patients across 15 entities approximately 2 years after diagnosis. Fatigue was assessed with the multidimensional EORTC QLQ‐FA12 questionnaire. Physical, emotional, cognitive, and total fatigue were compared across entities and with normative values of the general population. Differences in patients' characteristics and cancer therapy between entities were taken into account using analyses of covariance models. Results Across all entities, mean physical fatigue levels were significantly higher than age‐ and sex‐matched means of the general population for all cancer entities (all Bonferroni‐Holm adjusted P < .01). For most entities also emotional and cognitive fatigue levels were significantly higher than normative values. Age‐ and sex‐standardized physical fatigue prevalence ranged from 31.8% among prostate to 51.7% among liver cancer patients. Differences between entities could not be fully explained by sex, age, BMI, or cancer therapy. Adjusted for these factors, mean physical fatigue was higher for stomach (P = .0004), lung (P = .034), kidney (P = .0011), pancreas (P = .081), and endometrium (P = .022) compared to breast cancer patients. Adjusted means of emotional fatigue were also lowest in breast cancer patients and significantly higher in stomach (P = .0047), bladder (P = .0036), and rectal (P = .0020) cancer patients. Conclusions Physical, emotional, and cognitive fatigue is prevalent in all 15 investigated cancer entities even 2 years after diagnosis. Fatigue in breast cancer patients, the so‐far most studied group, is in the lowest range among all entities, suggesting that the extent of fatigue is still insufficiently determined. Entity‐specific problems might need to be considered in the treatment of fatigue.

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Section: Discussionmentioning

confidence: 99%

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confidence: 95%

Prevalence and severity of long‐term physical, emotional, and cognitive fatigue across 15 different cancer entities

et al. 2020

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“…Previously, the prevalence of fatigue in cancer survivors has been examined in reviews, with the use of immune checkpoint inhibitors, mammalian target of rapamycin (mTOR), and VEGF receptor. [51,52] The results demonstrated that the use of mTOR and VEGF receptor inhibitors is associated with a significantly increased risk of all-grade fatigue, but not for high-grade fatigue. However, to date, only a narrative review examined the safety results of MET inhibitors, which was not estimated with a meta-analysis.…”

Section: Discussionmentioning

confidence: 99%

Incidence and risk of fatigue in cancer patients treated with MET inhibitors

2019

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Fatigue associated with newly approved vascular endothelial growth factor receptor tyrosine kinase inhibitors in cancer patients: an up-to-date meta-analysis

2017

Int J Clin Oncol

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The fatigue associated with five newly approved vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) (regorafenib, vandetanib, cabozantinib, lenvatinib, axitinib) is poorly understood. We conducted this systematic review to fully investigate the fatigue associated with these VEGFR-TKIs in cancer patients. Relevant studies of randomized controlled trials in cancer patients treated with the five VEGFR-TKIs were retrieved and a systematic evaluation was conducted. EMBASE, MEDLINE, and PubMed were searched for articles published until March 2017. Thirteen randomized controlled trials and 4395 patients were included. The current analysis suggested that the use of five newly approved VEGFR-TKIs increased the risk of all-grade fatigue (1.43; 95% CI 1.23-1.66; p < 0.00001) and high-grade (≥grade 3) fatigue (1.97; 95% CI1.44-2.70; p < 0.0001). On subgroup analysis, the risk ratio (RR) of all-grade fatigue varied significantly within drug type, but high-grade fatigue did not. The RR of all-grade and high-grade fatigue did not vary significantly according to cancer type, treatment line, and treatment duration. The risk of high-grade fatigue may vary with treatment duration, whereas all-grade fatigue may not. The available data suggest that the use of the five newly approved VEGFR-TKIs is associated with a significantly increased risk of fatigue in cancer patients. Physicians should be aware of this adverse effect and should monitor cancer patients receiving these drugs.

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Fatigue with vascular endothelial growth factor receptor tyrosine kinase inhibitors and mammalian target of rapamycin inhibitors in patients with renal cell carcinoma (RCC) and other malignancies: A meta-analysis of randomized clinical trials

Cited by 8 publications

References 50 publications

Prevalence and severity of long‐term physical, emotional, and cognitive fatigue across 15 different cancer entities

Prevalence and severity of long‐term physical, emotional, and cognitive fatigue across 15 different cancer entities

Incidence and risk of fatigue in cancer patients treated with MET inhibitors

Fatigue associated with newly approved vascular endothelial growth factor receptor tyrosine kinase inhibitors in cancer patients: an up-to-date meta-analysis

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