Adverse reactions of targeted therapy in cancer patients: a retrospective study of hospital medical data in China

Abstract

Background The adverse reactions (ADRs) of targeted therapy were closely associated with treatment response, clinical outcome, quality of life (QoL) of patients with cancer. However, few studies presented the correlation between ADRs of targeted therapy and treatment effects among cancer patients. This study was to explore the characteristics of ADRs with targeted therapy and the prognosis of cancer patients based on the clinical data. Methods A retrospective secondary data analysis was conducted within an ADR data set including 2703 patients with targeted therapy from three Henan medical centers of China between January 2018 and December 2019. The significance was evaluated with chi-square test between groups with or without ADRs. Univariate and multivariate logistic regression with backward stepwise method were applied to assess the difference of pathological characteristics in patients with cancer. Using the univariate Cox regression method, the actuarial probability of overall survival was performed to compare the clinical outcomes between these two groups. Results A total of 485 patients were enrolled in this study. Of all patients, 61.0% (n = 296) occurred ADRs including skin damage, fatigue, mucosal damage, hypertension and gastrointestinal discomfort as the top 5 complications during the target therapy. And 62.1% of ADRs were mild to moderate, more than half of the ADRs occurred within one month, 68.6% ADRs lasted more than one month. Older patients (P = 0.022) and patients with lower education level (P = 0.036), more than 2 comorbidities (P = 0.021), longer medication time (P = 0.022), drug combination (P = 0.033) and intravenous administration (P = 0.019) were more likely to have ADRs. Those with ADRs were more likely to stop taking (P = 0.000), change (P = 0.000), adjust (P = 0.000), or not take the medicine on time (P = 0.000). The number of patients with recurrence (P = 0.000) and metastasis (P = 0.006) were statistically significant difference between ADRs and non-ADRs group. And the patients were significantly poor prognosis in ADRs groups compared with non-ADRs group. Conclusion The high incidence of ADRs would affect the treatment and prognosis of patients with cancer. We should pay more attention to these ADRs and develop effective management strategies.

Analysis of Influence Factors of Quality of Life of Lung Cancer Patients with Skin Adverse Drug Reactions Under Targeted Therapy

“…As con rmed by previous studies, patients with comorbidities and performing combined medicine applications normally had more complicated conditions, the interactions of diseases and drugs might lead to worse body function and aggravation of skin ADRs [29]. Our previous retrospective study indicated that the level of education affected the QoL, which was further con rmed in this study [30]. Indeed, poorly educated patients generally lacked the awareness to actively gain information to improve their QoL.…”

Tolerability on Serious Adverse Events of First-Line Bevacizumab and Cetuximab for RAS Wild-Type Metastatic Colorectal Cancer: A Systematic Review and Meta-Analysis

“…Nonetheless, the risk of AEs is markedly attenuated with targeted therapy administered concomitantly with backbone chemotherapy (FOLFOX, FOLFIRI, CAPEOX, or FOLFOXIRI) for CRC [ 18 , 19 ]. According to a retrospective study, the risk of AEs is substantially elevated with drug combinations and intravenous chemotherapy administration, being the major route of administration of both chemotherapy and targeted therapy agents in mCRC patients [ 6 ]. However, up to now, a choice of effective first-line biologic chemo-treatment with either cetuximab or bevacizumab in patients with RAS wild-type for mCRC is a still controversial.…”

“…EGFR inhibitors, on the other hand, are only recommended in patients with RAS wild-type left-sided mCRC, as EGFR antibodies only elicit responses in patients with RAS wild-type mCRC, implying that genetic variability is significantly associated with patient outcomes [ 3 ]. Previous studies demonstrated superior efficacy of cetuximab over bevacizumab [ 4 , 5 ]; however, comprehensive comparative analysis on tolerability, especially on serious adverse events (SAEs) in patients receiving cetuximab or bevacizumab is still lacking despite markedly increased the risk of adverse events (AEs) with concomitant administration of chemotherapy such as 5-fluorouracil, leucovorin, irinotecan, or oxaliplatin [ 6 ]. In general, the choice of first-line treatment should be influenced by the tolerability of the medication as well as the patient’s characteristic and efficacy outcomes [ 6 ].…”

“…Previous studies demonstrated superior efficacy of cetuximab over bevacizumab [ 4 , 5 ]; however, comprehensive comparative analysis on tolerability, especially on serious adverse events (SAEs) in patients receiving cetuximab or bevacizumab is still lacking despite markedly increased the risk of adverse events (AEs) with concomitant administration of chemotherapy such as 5-fluorouracil, leucovorin, irinotecan, or oxaliplatin [ 6 ]. In general, the choice of first-line treatment should be influenced by the tolerability of the medication as well as the patient’s characteristic and efficacy outcomes [ 6 ]. Thus, the purpose of the study is to assess tolerability, in terms of comprehensive systemic SAE profiles, of bevacizumab and cetuximab, and to provide guidance on the selection of appropriate targeted therapeutic agents in patients with RAS wild-type tumors.…”

Suspected Adverse Drug Reactions in Pediatric Cancer Patients in China: An Analysis of Henan Province Spontaneous Reporting System Database

“…Although many combinations of drugs have been found effective in relevant studies, formulating reasonable drug treatment strategies are still needed to minimize the risk of ADRs in children. In order to minimize the risk of SADRs, physicians should pay particular attention to children who are prescribed two or more drugs and closely monitor drug administration and ( 32 ).…”