The risk of hand foot skin reaction to pazopanib, a novel multikinase inhibitor: A systematic review of literature and meta-analysis Journal Article


Authors: Balagula, Y.; Wu, S.; Su, X.; Feldman, D. R.; Lacouture, M. E.
Article Title: The risk of hand foot skin reaction to pazopanib, a novel multikinase inhibitor: A systematic review of literature and meta-analysis
Abstract: Pazopanib is a novel multikinase inhibitor that shares a similar spectrum of target receptors with sorafenib and sunitinib. We have performed a systematic analysis to investigate the risk of HFSR to pazopanib and compare the difference in incidence between sorafenib, sunitinib, and pazopanib. Relevant studies were identified from PubMed (1998-2010) and abstracts presented at the American Society of Clinical Oncology Conferences between 2004 and 2010. Eligible studies were limited to prospective Phase II-III clinical trials in which cancer patients were treated with pazopanib 800 mg orally once daily. Incidence, relative risk (RR), and 95% confidence intervals were calculated using random-effects or fixed-effects models based on the heterogeneity of included studies. A total of 1,163 patients from 10 prospective clinical trials were included in the analysis. The overall incidence of all-grade and high-grade HFSR was 4.5% (95% CI: 2.5-7.9%) and 1.8% (95% CI: 0.7-4.6%), respectively. The relative risks of all-grade and high-grade HFSR to pazopanib monotherapy in comparison with controls were increased for allgrade (RR=6.09, 95% CI: 1.11-33.36, p=0.037) and highgrade HFSR (RR=2.51, 95% CI: 0.12-51.9, p=0.55). The risk of all-grade and high-grade HFSR to pazopanib was significantly lower as compared to sorafenib and sunitinib (RR=7.5, 95% CI: 5.5-10.2, p<0.001; RR=5.9, 95% CI: 3.5-10.0, p<0.001 and RR=4.2, 95% CI: 3.0-5.7, p< 0.001; RR=3.6, 95% CI: 2.1-6.2, p<0.001). Despite sharing the same spectrum of target receptors with sorafenib and sunitinib, pazopanib is associated with an unexpectedly low risk of HFSR. Further investigations are needed to elucidate HFSR pathogenesis. © Springer Science+Business Media, LLC 2011.
Keywords: review; sorafenib; placebo; sunitinib; monotherapy; solid tumor; hand foot skin reaction; cancer patient; lung non small cell cancer; kidney carcinoma; risk assessment; uterine cervix cancer; pazopanib; nasopharynx carcinoma; octreotide; tyrosine kinase inhibitor; hand foot syndrome; lapatinib; soft tissue tumor; uterine cervix carcinoma; randomized controlled trial (topic); phase 2 clinical trial (topic); meta analysis (topic); phase 3 clinical trial (topic); dermatologic toxicity; systematic review (topic)
Journal Title: Investigational New Drugs
Volume: 30
Issue: 4
ISSN: 0167-6997
Publisher: Springer  
Date Published: 2012-08-01
Start Page: 1773
End Page: 1781
Language: English
DOI: 10.1007/s10637-011-9652-2
PROVIDER: scopus
PUBMED: 21394443
DOI/URL:
Notes: --- - "Cited By (since 1996): 1" - "Export Date: 2 November 2012" - "CODEN: INNDD" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Mario E Lacouture
    276 Lacouture
  2. Darren Richard Feldman
    172 Feldman