Safety Assessment on Serious Adverse Events of Targeted Therapeutic Agents Prescribed for RAS Wild-Type Metastatic Colorectal Cancer: Systematic Review and Network Meta-Analysis
- 주제(키워드) adverse events , bevacizumab , cetuximab , colorectal cancer , metastatic cancer , panitumumab , pharmacovigilance
- 주제(기타) Environmental Sciences
- 주제(기타) Public, Environmental & Occupational Health
- 설명문(일반) [Choi, Yeo Jin] Kyung Hee Univ, Dept Pharm, Coll Pharm, Seoul 02447, South Korea; [Choi, Yeo Jin] Kyung Hee Univ, Grad Sch, Dept Regulatory Sci, Seoul 02447, South Korea; [Choi, Chang-Young] Ajou Univ, Med Ctr, Dept Internal Med, Suwon 16499, South Korea; [Rhie, Sandy Jeong] Ewha Womans Univ, Grad Sch Converging Clin & Publ Hlth, Seoul 03670, South Korea; [Rhie, Sandy Jeong] Ewha Womans Univ, Grad Sch Pharmaceut Sci, Coll Pharm, Seoul 03760, South Korea; [Shin, Sooyoung] Ajou Univ, Dept Pharm, Coll Pharm, Suwon 16499, South Korea
- 등재 SCIE, SSCI, SCOPUS
- OA유형 gold, Green Published
- 발행기관 MDPI
- 발행년도 2022
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000194491
- 본문언어 영어
- Published As https://doi.org/10.3390/ijerph19159196
- PubMed https://pubmed.ncbi.nlm.nih.gov/35954563
초록/요약
Despite substantially elevated risk of serious adverse events (SAEs) from targeted therapy in combination with chemotherapy, comprehensive pharmacovigilance research is limited. This study aims to systematically assess SAE risks of commonly prescribed targeted agents (bevacizumab, cetuximab, and panitumumab) in patients with rat sarcoma viral oncogene homolog (RAS) wild-type metastatic colon cancer. Keyword searches of Cochrane Library, Clinical Key and MEDLINE were conducted per PRISMA-NMA guidelines. Frequentist network meta-analysis was performed with eight randomized controlled trials to compare relative risk (RR) of 21 SAE profiles. The risks of hematological, gastrointestinal, neurological SAE were insignificant among targeted agents (p > 0.05). The risk of serious hypertension was substantially elevated in bevacizumab-based chemotherapy (p < 0.05), whereas panitumumab-based chemotherapy had markedly elevated risk of serious thromboembolism (RR 3.65; 95% CI 1.30-10.26). Although both cetuximab and panitumumab demonstrated increased risk of serious dermatological and renal toxicities, panitumumab-based chemotherapy has relatively higher risk of skin toxicity (RR 15.22; 95% CI 7.17-32.35), mucositis (RR 3.18; 95% CI 1.52-6.65), hypomagnesemia (RR 20.10; 95% CI 5.92-68.21), and dehydration (RR 2.81; 95% CI 1.03-7.67) than cetuximab-based chemotherapy. Thus, further studies on risk stratification and SAE management are warranted for safe administration of targeted agents.
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