Congestive heart failure with vascular endothelial growth factor receptor tyrosine kinase inhibitors

Crit Rev Oncol Hematol. 2015 May;94(2):228-37. doi: 10.1016/j.critrevonc.2014.12.008. Epub 2014 Dec 19.

Abstract

A systematic review and meta-analysis was conducted to determine the relative risk (RR) of congestive heart failure (CHF) associated with approved multi-targeted vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKI). Eligible studies included randomized trials comparing arms with and without an FDA-approved VEGFR TKI. Statistical analyses calculated the relative risk (RR) and 95% confidence intervals (CI). A total of 10,647 patients from 16 phase III trials and 5 phase II trials were selected. All grade CHF occurred in 138 of 5752 (2.39%) patients receiving VEGFR TKIs and 37 of 4895 (0.75%) patients in the non-TKI group. High-grade CHF occurred in 17 of 1426 (1.19%) patients receiving VEGFR TKIs and 8 of 1232 (0.65%) patients in the non-TKI group. The RR of all grade and high-grade CHF for the TKI vs. no TKI arms was 2.69 (p<0.001; 95% CI: 1.86 to 3.87) and 1.65 (p=0.227, 95% CI: 0.73 to 3.70), respectively. The RR of relatively specific TKIs (axitinib) was similar to relatively non-specific TKIs (sunitinib, sorafenib, vandetanib, pazopanib).

Keywords: Approved; Congestive heart failure; Meta-analysis; Tyrosine kinase inhibitors; Vascular endothelial growth factor receptor.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Antineoplastic Agents / adverse effects*
  • Heart Failure / etiology*
  • Humans
  • Neoplasms / complications*
  • Neoplasms / drug therapy
  • Odds Ratio
  • Protein Kinase Inhibitors / adverse effects*
  • Publication Bias
  • Randomized Controlled Trials as Topic
  • Receptors, Vascular Endothelial Growth Factor / antagonists & inhibitors*
  • Risk

Substances

  • Antineoplastic Agents
  • Protein Kinase Inhibitors
  • Receptors, Vascular Endothelial Growth Factor