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Sunitinib, sorafenib therapy up risk of arterial clots

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – Sunitinib and sorafenib significantly increase patients’ risk of arterial thromboembolic events, according to a report in the March 29th online issue of the Journal of Clinical Oncology.

These agents – both vascular endothelial growth factor (VEGF) receptor tyrosine kinase inhibitors – are known to be associated with such events, although the overall risk remains unclear, according to lead author Dr. Toni K. Choueiri, from Brigham and Women’s Hospital, Boston, and colleagues.

To better understand the risks, the authors conducted a systematic review and meta-analysis of clinical trials identified through a search of PubMed (January 1966 to July 2009) and abstracts presented at the American Society of Clinical Oncology and the European Society of Medical Oncology meeting from 2004 to 2009.

Ultimately the researchers included 10 trials involving 10,255 patients. The rate of arterial thromboembolic events was 1.4%. Patients treated with sorafenib and sunitinib were three times more likely than controls to have arterial thromboembolic events (p = 0.015).

Neither the underlying cancer nor the specific drug used had a significant impact on the association, the report indicates.

“We found that VEGF receptor tyrosine kinase inhibitors are associated with a significant increase in the risk of arterial thrombosis,” the researchers conclude.

“Clinicians should be aware of the possibility…especially in patients at higher risk, and adverse effects of VEGF receptor tyrosine kinase inhibitors warrant careful, continued surveillance and prompt reporting,” they add.


J Clin Oncol 2010.