Proteinuria in Patients with Solid Tumors Treated with Ramucirumab: A Systematic Review and Meta-Analysis

Abstract

Background: We performed a systematic review and meta-analysis of the risk of proteinuria associated with ramucirumab. Methods: Eligible studies included randomized phase II and III trials of patients with solid tumors on ramucirumab, describing events of all-grade and high-grade proteinuria. Results: Our search strategy yielded 170 potentially relevant citations from PubMed/Medline, CENTRAL Cochrane database, ASCO and ESMO meeting libraries. After exclusion of ineligible studies, a total of 11 clinical trials were considered eligible for the meta-analysis. The relative risk (RR) of all-grade proteinuria was 3.31 (95% CI 2.48-4.42; p < 0.00001). Moreover, the RR of high-grade proteinuria was 5.28 (95% CI 2.32-12.01; p < 0.0001). Conclusions: Our meta-analysis has demonstrated that ramucirumab use is associated with an increased risk of all-grade and high-grade proteinuria. Early detection strategies should be employed in those patients to prevent the progression to more sinister renal disease.

Efficacy and safety assessment of apatinib in patients with advanced gastric cancer: a meta-analysis

“…This might have restricted the application of apatinib in patients with AGC, especially with poor performance status of 2 or 3. Ramucirumab has been reported to show AEs, including proteinuria, 28 stomatitis and gastrointestinal perforation, 29 hypertension, 30 and hematological toxicity. 31 However, RCTs included in this meta-analysis did not report gastrointestinal perforation during the treatment with apatinib.…”

Specialists to the Rescue of Oncologists for the Management of Toxicity Occurring Under Combination of Anticancer Therapies

“…5 Only a few case reports have been published describing the efficacy of the combination of crizotinib and EGFR TKIs, and only one with osimertinib. [1][2][3][4] We report here cases showing tumor response with this treatment strategy, even if progression occurred quickly in one patient. Prospective clinical trials are needed to address this issue.…”

“…Only a few reports have been made concerning the treatment of acquired MET amplification in EGFR-mutated adenocarcinoma. [1][2][3][4] We here report the outcomes of two patients treated with an association of EGFR-TKI and crizotinib for EGFR-mutated adenocarcinoma with acquired MET amplification.…”

Adverse events risk associated with anti-VEGFR agents in the treatment of advanced nonsmall-cell lung cancer

“…However, VEGF plays multiple roles in physiologic processes, and thus its inhibition could have potentially serious systemic consequences. Although previous researches have shown that anti-VEGFR agents significantly increases the risk of developing anti-VEGF adverse events, including hypertension, [39–41] hemorrhage, [42,43] proteinuria, [44,45] gastrointestinal perforation, [46] congestive heart failure, [47–49] and thromboembolic events. [50–53] , the risk of these adverse events in advanced NSCLC remains unknown.…”