Pruritus in patients treated with targeted cancer therapies: Systematic review and meta-analysis

Abstract

Background Pruritus has been anecdotally described in association with targeted cancer therapies. The risk of pruritus has not been systematically ascertained. Objective A systematic review and meta-analysis of the literature was conducted for axitinib, cetuximab, dasatinib, erlotinib, everolimus, gefitinib, imatinib, ipilimumab, lapatinib, nilotinib, panitumumab, pazopanib, rituximab, sorafenib, temsirolimus, tositumomab, vandetanib, and vemurafenib. Methods Databases from PubMed, Web of Science (01/1998–07/2012), and American Society of Clinical Oncology abstracts (2004–2012) were searched. Incidence and risk (RR) of pruritus were calculated using random or fixed effects model. Results The incidences of all-grade and high-grade pruritus were 17.4% (95% confidence interval (CI): 16.0%−19.0%) and 1.4% (95% CI: 1.2%−1.6%), respectively. There was an increased risk of all-grade pruritus (RR=2.90 (95% CI: 1.76–4.77, p<0.001)); and variation among different drugs (P<0.001). Limitations The reporting of pruritus may vary, resulting from concomitant medications, comorbidities, and underlying malignancies. We found a higher incidence of pruritus in patients with solid tumors, concordant with those targeted therapies with the highest pruritus incidences. Conclusion There is a significant risk of developing pruritus in patients receiving targeted therapies. In order to prevent suboptimal dosing and decreased quality of life, patients should be counseled and treated against this untoward symptom.

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