PMID- 24914484
OWN - NLM
STAT- MEDLINE
DCOM- 20160324
LR  - 20211203
IS  - 1651-226X (Electronic)
IS  - 0284-186X (Linking)
VI  - 54
IP  - 1
DP  - 2015 Jan
TI  - Incidence and risk of rash to mTOR inhibitors in cancer patients--a meta-analysis 
      of randomized controlled trials.
PG  - 124-32
LID - 10.3109/0284186X.2014.923583 [doi]
AB  - BACKGROUND: Inhibitors of the mammalian target of rapamycin (mTOR) are currently 
      approved for the treatment of several cancers, and their use is associated with 
      serious rash, which affects patient's quality of life and leads to undesirable 
      dose reductions or interruptions. A meta-analysis of randomized controlled trials 
      (RCTs) was performed to determine the overall risk of developing high-grade rash 
      with mTOR inhibitors in cancer patients. METHODS: We searched the PubMed database 
      and abstracts presented at the American Society of Clinical Oncology (ASCO) 
      meetings up to December 2013 for relevant studies. Eligible studies included RCTs 
      in which everolimus or temsirolimus was compared to controls in cancer patients. 
      The summary incidence, relative risk (RR), and 95% confidence intervals (CI) were 
      calculated using a random- or fixed-effects model depending on the heterogeneity 
      of the included trials. RESULTS: A total of 11 RCTs with 4752 patients (mTORs: 
      2725, controls: 2027) with a variety of solid tumors were included in the 
      analysis. The incidences of all-grade (grade 1-4) and high-grade rash (grade 3-4) 
      were 27.3% (95% CI 21.0-34.7%) and 1.0% (95% CI 0.6-1.4%), respectively. In 
      comparison with controls, mTOR inhibitors significantly increased the risk for 
      developing all-grade rash (RR = 3.55, 95% CI 3.0-4.20, p < 0.001) and high-grade 
      rash (RR = 4.25, 95% CI 1.63-11.10, p = 0.003). The increased risk of high-grade 
      rash did not vary significantly among different tumors (p = 0.91). There was no 
      significant difference between everolimus and temsirolimus (p = 0.60). There was 
      also no significant difference between mTOR inhibitors alone and in combination 
      with other agents (p = 0.57). CONCLUSIONS: Everolimus and temsirolimus 
      significantly increased the risk of high-grade rash in cancer patients. Early 
      recognition and appropriate treatment is recommended.
FAU - Shameem, Raji
AU  - Shameem R
AD  - Department of Internal Medicine, Lenox Hill Hospital , New York, New York , USA.
FAU - Lacouture, Mario
AU  - Lacouture M
FAU - Wu, Shenhong
AU  - Wu S
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
DEP - 20140610
PL  - Sweden
TA  - Acta Oncol
JT  - Acta oncologica (Stockholm, Sweden)
JID - 8709065
RN  - 0 (Protein Kinase Inhibitors)
RN  - 624KN6GM2T (temsirolimus)
RN  - 9HW64Q8G6G (Everolimus)
RN  - EC 2.7.11.1 (TOR Serine-Threonine Kinases)
RN  - W36ZG6FT64 (Sirolimus)
SB  - IM
MH  - Drug Eruptions/epidemiology/*etiology
MH  - Everolimus/*adverse effects
MH  - Exanthema/*chemically induced/epidemiology
MH  - Humans
MH  - Incidence
MH  - Protein Kinase Inhibitors/*adverse effects
MH  - Randomized Controlled Trials as Topic
MH  - Risk
MH  - Sirolimus/adverse effects/*analogs & derivatives
MH  - TOR Serine-Threonine Kinases/*antagonists & inhibitors
EDAT- 2014/06/11 06:00
MHDA- 2016/03/25 06:00
CRDT- 2014/06/11 06:00
PHST- 2014/06/11 06:00 [entrez]
PHST- 2014/06/11 06:00 [pubmed]
PHST- 2016/03/25 06:00 [medline]
AID - 10.3109/0284186X.2014.923583 [doi]
PST - ppublish
SO  - Acta Oncol. 2015 Jan;54(1):124-32. doi: 10.3109/0284186X.2014.923583. Epub 2014 
      Jun 10.