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Treatment-related mortality with aflibercept in cancer patients: a meta-analysis

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Abstracts

Purpose

Aflibercept, a fully humanized vascular endothelial growth factor (VEGF)-targeted agent, has emerged as an effective therapy in the treatment of various solid tumors. We carried out an up-to-date meta-analysis to determine the risk of fatal adverse events (FAEs) in cancer patients treated with aflibercept.

Methods

We searched databases such as PubMed and Web of Science, and abstracts presented at the American Society of Clinical Oncology (ASCO) and the European Society of Medical Oncology (ESMO) meetings for records up to August 2013 to identify relevant studies. Eligible studies included prospective phase II and III trials evaluating aflibercept in cancer patients with adequate data on FAEs. Statistical analyses were conducted to calculate the summary incidence, odds ratio (OR) and 95 % confidence intervals (CIs) by using either random effects or fixed-effect models according to the heterogeneity of included studies.

Results

A total of 3,060 patients with a variety of solid tumors from ten clinical trials were included in our analysis. The overall incidence of FAEs associated with aflibercept was 5.1 % (95%CI: 3.8-6.8 %). The use of aflibercept significantly increased the risk of FAEs compared to patients treated with control medication (OR 1.81, 95 % CI: 1.20–2.72, p = 0.004). Additionally, the most common causes of FAEs were infection (38.8 %), hemorrhage (5.9 %) and GI perforation (5.9 %), respectively.

Conclusions

With available evidence, the use of aflibercept is associated with an increased risk of FAEs compared to controls. Further studies are still needed to investigate this association. In the appropriate clinical scenario, the use of aflibercept remains justified in its approved indications.

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All authors declare that they have no potential conflicts of interests.

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Authors and Affiliations

  1. Department of Oncology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, No. 600, Yishan road, Shanghai, 200233, China

    Wei-**ang Qi, Li-Na Tang, Zan Shen & Yang Yao

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  1. Wei-**ang Qi
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  2. Li-Na Tang
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  3. Zan Shen
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  4. Yang Yao
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Correspondence to Yang Yao.

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Author contributions

Conception/design: Wei-xiang Qi, Yang Yao;

Collection and/or assembly of data: Zan Shen, Li-Na Tang

Data analysis and interpretation: Wei-xiang Qi, Yang Yao

Manuscript writing: Wei-xiang Qi,

Final approval of manuscript: Wei-xiang Qi, Li-Na Tang, Yang Yao, Zan Shen,

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Qi, WX., Tang, LN., Shen, Z. et al. Treatment-related mortality with aflibercept in cancer patients: a meta-analysis. Eur J Clin Pharmacol 70, 461–467 (2014). https://doi.org/10.1007/s00228-013-1633-2

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