Authors: WeiXiang Qi Fu Shen Zhang Qing Guo XiaoMao
Publish Date: 2014/07/30
Volume: 35, Issue: 11, Pages: 10715-10722
Abstract
Gastrointestinal GI perforation is a serious adverse event associated with aflibercept a novel vascular endothelial growth factor VEGFtargeted agent currently approved as secondline treatment for previously treated metastatic colorectal cancer but the incidence and risk of GI perforation associated with aflibercept has not been well determined We thus conducted this metaanalysis to investigate the overall incidence and risk of developing GI perforation associated with aflibercept Databases from PubMed Web of Science and abstracts presented at American Society of Clinical Oncology ASCO and European Society of Medical Oncology ESMO meeting up to January 2014 were searched to identify relevant studies Eligible studies included prospective phase II and III trials evaluating aflibercept in cancer patients with adequate data on GI perforation Statistical analyses were conducted to calculate the summary incidence odds ratio and 95 confidence intervals CIs by using either random effects or fixed effect models according to the heterogeneity of included studies A total of 4101 patients with a variety of solid tumors from eight clinical trials were included in our analysis The incidence of GI perforation associated with aflibercept was 19 95 CI 10–38 with a mortality of 108 95CI 41–255 In addition patients treated with aflibercept had a significantly increased risk of developing allgrade OR 376 95CI 194–725 p 0001 and highgrade GI OR 414 95 CI 212–806 p 0001 perforation compared with patients treated with control medication No evidence of publication bias was observed The use of aflibercept is associated with a significantly increased risk of GI perforation compared to controls
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