Pruritus in patients treated with targeted cancer therapies: Systematic review and meta-analysis - 23/10/13
Abstract |
Background |
Pruritus has been anecdotally described in association with targeted cancer therapies. The risk of pruritus has not been systematically ascertained.
Objective |
A systematic review and meta-analysis of the literature was conducted for axitinib, cetuximab, dasatinib, erlotinib, everolimus, gefitinib, imatinib, ipilimumab, lapatinib, nilotinib, panitumumab, pazopanib, rituximab, sorafenib, temsirolimus, tositumomab, vandetanib, and vemurafenib.
Methods |
Databases from PubMed, Web of Science (January 1998 through July 2012), and American Society of Clinical Oncology abstracts (2004 through 2012) were searched. Incidence and relative risk of pruritus were calculated using random- or fixed-effects model.
Results |
The incidences of all-grade and high-grade pruritus were 17.4% (95% confidence interval 16.0%-19.0%) and 1.4% (95% confidence interval 1.2%-1.6%), respectively. There was an increased risk of all-grade pruritus (relative risk 2.90 [95% confidence interval 1.76-4.77, P < .001]) and variation among different drugs (P < .001).
Limitations |
The reporting of pruritus may vary, resulting from concomitant medications, comorbidities, and underlying malignancies. We found a higher incidence of pruritus in patients with solid tumors, concordant with those targeted therapies with the highest pruritus incidences.
Conclusion |
There is a significant risk of developing pruritus in patients receiving targeted therapies. To prevent suboptimal dosing and decreased quality of life, patients should be counseled and treated against this untoward symptom.
Le texte complet de cet article est disponible en PDF.Key words : Bcr-Abl, cancer, CD20, epidermal growth factor receptor, inhibitor, itch, mammalian target of rapamycin, pruritus, Raf, vascular endothelial growth factor receptor
Abbreviations used : AE, CD20, CI, CTLA4, EGFR, EGFRIs, HER2, QoL, RR, VEGFR
Plan
Supported by a Dermatology Foundation Career and Development Award (M.E.L.). |
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Disclosure: Dr Lacouture has a consultant role with AstraZeneca, Roche, Bayer, Genentech, Bristol Myers Squibb, Novartis, Exelixis, and Advancell. He is also receiving research funding from Berg, Roche. Dr Wu has received honoraria from Onyx Pharmaceuticals, Pfizer, Jansen, and Novartis, and is a speaker for Onyx, Pfizer, Jansen, and Novartis. Ms Ensslin and Ms Rosen have no conflicts of interest to declare. |
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Reprints not available from the authors. |
Vol 69 - N° 5
P. 708-720 - novembre 2013 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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