Risk of fatigue in patients with solid tumors treated with everolimus, temsirolimus or ridaforolimus: a comparative meta-analysis

Expert Rev Anticancer Ther. 2015 Apr;15(4):477-86. doi: 10.1586/14737140.2015.1014342. Epub 2015 Feb 9.

Abstract

We performed a meta-analysis of fatigue associated with the use of everolimus, temsirolimus or ridaforolimus in patients with solid tumors. Eligible studies included randomized trials of patients with solid tumors on everolimus, temsirolimus or ridaforolimus describing events of fatigue. A total of 18 clinical trials including 8143 patients were considered eligible for the meta-analysis. On the basis of random-effects model, we found that the relative risk of all-grade and high-grade fatigue were 1.26 [95% CI: 1.09-1.46; p < 0.0001], 1.49 [95% CI: 0.99, 2.24; p = 0.05], respectively. On subgroup analysis, we cannot identify any difference between everolimus and temsirolimus in the risk of fatigue. Thus, our meta-analysis has demonstrated that regimens containing everolimus, temsirolimus or ridaforolimus for the treatment of solid tumors are associated with an increased risk of all-grade fatigue, whereas the risk of high-grade fatigue did not reach the threshold of statistical significance. Close clinical monitoring and pre-emptive treatment for fatigue are recommended.

Keywords: everolimus; fatigue; ridaforolimus; supportive care; temsirolimus.

Publication types

  • Comparative Study
  • Meta-Analysis

MeSH terms

  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use
  • Everolimus / adverse effects*
  • Everolimus / therapeutic use
  • Fatigue / chemically induced*
  • Fatigue / epidemiology
  • Humans
  • Neoplasms / drug therapy
  • Protein Kinase Inhibitors / adverse effects
  • Protein Kinase Inhibitors / therapeutic use
  • Randomized Controlled Trials as Topic
  • Risk
  • Sirolimus / adverse effects
  • Sirolimus / analogs & derivatives*
  • Sirolimus / therapeutic use

Substances

  • Antineoplastic Agents
  • Protein Kinase Inhibitors
  • ridaforolimus
  • temsirolimus
  • Everolimus
  • Sirolimus