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Review
, 93 (3), 257-76

Hepatotoxicity With Vascular Endothelial Growth Factor Receptor Tyrosine Kinase Inhibitors: A Meta-Analysis of Randomized Clinical Trials

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Review

Hepatotoxicity With Vascular Endothelial Growth Factor Receptor Tyrosine Kinase Inhibitors: A Meta-Analysis of Randomized Clinical Trials

Pooja Ghatalia et al. Crit Rev Oncol Hematol.

Abstract

A meta-analysis of randomized controlled trials (RCT) was conducted to determine the relative risk (RR) of hepatotoxicity with vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKI). Citations from PubMed/Medline, abstracts from major conferences, clinicaltrials.gov and package inserts were reviewed to include RCTs comparing arms with or without a VEGFR TKI. The RRs of all-grade ALT, AST, ALP and bilirubin elevation in 18,282 patients from 52 trials were 1.57 (95% CI 1.38-1.79, p<0.001), 1.57 (95% CI 1.36-1.81, p<0.001), 1.20 (95% CI 1.09-1.83, p<0.001) and 1.55 (95% CI 1.21-1.97, p<0.001) respectively, and high-grade elevations were 1.66 (95% CI 1.25-2.20, p=0.001), 1.61 (95% CI 1.21-2.14, p=0.001), 1.02 (95% CI 0.70-1.47, p=0.932) and 1.34 (95% CI 1.0-1.81, p=0.054) respectively compared to those in the non-TKI group. The incidence of hepatic failure with VEGFR TKIs was 0.8%.

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

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