Risk of Rash in Cancer Patients Treated with Vandetanib: Systematic Review and Meta-Analysis

Rosen, Alyx C.; Wu, Shenhong; Damse, Amelia; Sherman, Eric J.; Lacouture, Mario E.

doi:10.1210/jc.2011-2677

Cited by 46 publications

(38 citation statements)

References 38 publications

(52 reference statements)

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“…This is consistent with the results of a recent meta-analysis showing a 46% incidence of all grades of eruptions during vandetanib treatment. 5 We report herein 2 unusual skin toxic effects: frequent photosensitization and skin pigmentation observed in 37% and 19% of the patients, respectively. Doxycycline was used in some patients to treat folliculitis.…”

mentioning

confidence: 86%

A New Spectrum of Skin Toxic Effects Associated With the Multikinase Inhibitor Vandetanib

Giacchero¹,

Ramacciotti²,

Arnault³

et al. 2012

Arch Dermatol

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RESEARCH LETTERSA New Spectrum of Skin Toxic Effects Associated With the Multikinase Inhibitor Vandetanib S kin manifestations are among the most frequent adverse effects of targeted therapies. 1 Hyperkeratosis and hand-foot skin reaction are observed with most raf and vascular endothelial growth factor (VEGF) inhibitors, whereas folliculitis is a hallmark of epidermal growth factor receptor (EGFR) blocking agents. 1 Vandetanib (Zactima, ZD6474; AstraZeneca) is a multikinase inhibitor that targets EGFR, VEGF receptors 1, 2, and 3 and the RET (rearranged during transfection) receptor. 2 Methods. Between November 2005 and October 2009, patients with metastatic thyroid cancer received vandetanib at a dose of 300 mg/d in 3 clinical trials: a phase 2 open-label study (NCT00098345) 3 and 2 randomized phase 3 studies comparing vandetanib with a placebo (NCT00537095 and NCT00410761). Clinical examination of all patients exhibiting any skin manifestation was performed. Skin toxic effects were assessed using version 3 of the National Cancer Institute Common Terminology Criteria (http://ctep.cancer.gov/protocolDevelopment /electronic_applications/ctc.htm), and additional drug intake was recorded. All patients participating in this study provided a written informed consent for the clinical trials.This study was conducted according to the Declaration of Helsinki Good Clinical Practice guidelines and in accordance with applicable local laws and regulations.

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mentioning

confidence: 86%

A New Spectrum of Skin Toxic Effects Associated With the Multikinase Inhibitor Vandetanib

Giacchero¹,

Ramacciotti²,

Arnault³

et al. 2012

Arch Dermatol

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show abstract

“…[12][13][14][15][16][17] Although VEGFR TKIs related-AEs are generally manageable, the influence of VEGFR-TKIs on some clinically relevant AEs such as venous thromboembolism events (VTEs) and arterial thromboembolism events (ATEs) described in trials remains unclear. Recently, a systematic review and meta-analysis of RCTs with two VEGFR-TKIs (sunitinib and sorafenib) demonstrates a significant increase in the risk of ATEs with these agents, 18 and the anti-vascular endothelial growth factor agent bevacizumab has also been associated with an increase risk of VTEs in previous research.…”

mentioning

confidence: 99%

Risk of venous thromboembolic events associated with VEGFR‐TKIs: A systematic review and meta‐analysis

Min

Shen

et al. 2012

Intl Journal of Cancer

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Vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKIs) have been widely used in advanced cancers. Concerns have arisen regarding the risk of venous thromboembolism with the use of these drugs. Currently, the contribution of VEGFR-TKIs to venous thromboembolism is still unknown. We performed a meta-analysis to determine the incidence and relative risk (RR) of venous thromboembolism events (VTEs) associated with these agents. Eligible studies included phase II and III prospective trials evaluating US Food and Drug Administration approved VEGFR-TKIs (pazopanib, sunitinib, sorafenib and vandetanib), and data on VTEs were available. Overall incidence rates, RR and 95% confidence intervals (CI) were calculated employing fixed-or random-effects models depending on the heterogeneity of included trials. A total of 14 studies (4,430 patients) were selected for this meta-analysis. The incidence of VTEs related to VEGFR-TKIs was 3% (95%CI: 1.7-5.1%), and there was no statistically significant increase in the risk of VTEs for VEGFR-TKIs versus controls in overall population (RR0.912, 95%CI: 0.617-1.348, p 5 0.643). On subgroup analysis, no significant increase in the risk of VTEs was found among different VEGFR-TKIs or tumor types. No evidence of publication bias was observed. The use of VEGFRTKIs does not significantly increase the risk of VTEs, the risk of VTEs in patients with cancer is driven predominantly by tumor types, host factors and concomitant usage of anticancer agents. These results would provide important information for clinicians who use VEGFR-TKIs to treat patients with solid cancer.

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“…): Some of the anti-HER2 agents used in breast cancer can result in acneiform rash. Lapatinib is associated with rash in 50% of patients, but it is not severe (Rosen, Wu, Damse, Sherman, & Lacouture, 2012). Rash is rare with trastuzumab, but it can occur.…”

Section: Acneiform Rash: Biggest Offendersmentioning

confidence: 99%

Management of Dermatologic Toxicities Associated With Targeted Therapy

Lacouture

2016

JADPRO

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Risk of Rash in Cancer Patients Treated with Vandetanib: Systematic Review and Meta-Analysis

Cited by 46 publications

References 38 publications

A New Spectrum of Skin Toxic Effects Associated With the Multikinase Inhibitor Vandetanib

A New Spectrum of Skin Toxic Effects Associated With the Multikinase Inhibitor Vandetanib

Risk of venous thromboembolic events associated with VEGFR‐TKIs: A systematic review and meta‐analysis

Management of Dermatologic Toxicities Associated With Targeted Therapy

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