PMID- 36383456
OWN - NLM
STAT- MEDLINE
DCOM- 20230217
LR  - 20231213
IS  - 1945-7197 (Electronic)
IS  - 0021-972X (Linking)
VI  - 108
IP  - 3
DP  - 2023 Feb 15
TI  - Efficacy and Safety of Tyrosine Kinase Inhibitors in Patients with Metastatic 
      Pheochromocytomas/Paragangliomas.
PG  - 755-766
LID - 10.1210/clinem/dgac657 [doi]
AB  - CONTEXT: Tyrosine kinase inhibitors (TKIs) can be used to treat locally 
      unresectable or distantly metastatic pheochromocytomas/paragangliomas (PPGLs), 
      such as sunitinib, according to the National Comprehensive Cancer Network 
      guidelines in 2022. However, the precise effect of different TKIs in metastatic 
      PPGLs is still unclear. OBJECTIVE: The aim of this meta-analysis is to assess the 
      efficacy and safety of TKIs in metastatic PPGLs. METHODS: The PubMed, Cochrane 
      Library, Scopus, Clinical Trial, and Embase databases were searched by synonyms 
      of 48 TKIs and metastatic PPGLs from inception up to August 2022. Outcomes were 
      tumor response or survival data and the incidence of adverse events (AEs) after 
      treatment. The MIONRS scale and the JBI's tools for case series were used for 
      interventional and observational studies to assess risk of bias, respectively. 
      The combined effects with fixed- or random-effect models, the combined median 
      with the weighted median of medians method and their 95% CIs were reported. 
      RESULTS: A total of 7 studies with 160 patients were included. Tumor responses in 
      metastatic PPGLs in 5 studies with available data showed the pooled proportion of 
      partial response (PR), stable disease, and disease control rate (DCR) of, 
      respectively, 0.320 (95% CI 0.155-0.486), 0.520 (95% CI 0.409-0.630), and 0.856 
      (95% CI 0.734-0.979). The combined median progressive-free survival in 6 studies 
      was 8.9 months (95% CI 4.1-13.5) and the proportion of those who discontinued due 
      to AEs in 5 studies was 0.143 (95% CI 0.077-0.209). CONCLUSION: This 
      meta-analysis suggests that patients with metastatic PPGLs can benefit from TKI 
      therapy with PR and DCR up to more than 30% and 80%. However, because of 
      restricted studies, larger clinical trials should be performed in the future.
CI  - (c) The Author(s) 2022. Published by Oxford University Press on behalf of the 
      Endocrine Society. All rights reserved. For permissions, please e-mail: 
      journals.permissions@oup.com.
FAU - Zhou, Yue
AU  - Zhou Y
AUID- ORCID: 0000-0002-2639-6934
AD  - Department of Endocrinology, Key Laboratory of Endocrinology, National Health 
      Commission of the People's Republic of China, Peking Union Medical College 
      Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 
      Beijing 100730, China.
FAU - Cui, Yunying
AU  - Cui Y
AD  - Department of Endocrinology, Key Laboratory of Endocrinology, National Health 
      Commission of the People's Republic of China, Peking Union Medical College 
      Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 
      Beijing 100730, China.
FAU - Zhang, Dingding
AU  - Zhang D
AUID- ORCID: 0000-0002-5234-752X
AD  - Medical Research Center, State Key laboratory of Complex Severe and Rare 
      Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical 
      Sciences and Peking Union Medical College, Beijing 100730, China.
FAU - Tong, Anli
AU  - Tong A
AUID- ORCID: 0000-0002-1418-1012
AD  - Department of Endocrinology, Key Laboratory of Endocrinology, National Health 
      Commission of the People's Republic of China, Peking Union Medical College 
      Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 
      Beijing 100730, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Clin Endocrinol Metab
JT  - The Journal of clinical endocrinology and metabolism
JID - 0375362
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Tyrosine Kinase Inhibitors)
RN  - 0 (Protein Kinase Inhibitors)
SB  - IM
MH  - Humans
MH  - *Antineoplastic Agents/therapeutic use
MH  - Tyrosine Kinase Inhibitors
MH  - Protein Kinase Inhibitors/adverse effects
MH  - *Pheochromocytoma/drug therapy
MH  - *Paraganglioma/drug therapy
MH  - *Adrenal Gland Neoplasms/drug therapy
OTO - NOTNLM
OT  - MPPGL
OT  - TKI
OT  - meta-analysis
OT  - metastatic pheochromocytomas/paragangliomas
OT  - systematic review
OT  - tyrosine kinase inhibitors
EDAT- 2022/11/17 06:00
MHDA- 2023/02/18 06:00
CRDT- 2022/11/16 12:33
PHST- 2022/09/08 00:00 [received]
PHST- 2022/11/17 06:00 [pubmed]
PHST- 2023/02/18 06:00 [medline]
PHST- 2022/11/16 12:33 [entrez]
AID - 6831422 [pii]
AID - 10.1210/clinem/dgac657 [doi]
PST - ppublish
SO  - J Clin Endocrinol Metab. 2023 Feb 15;108(3):755-766. doi: 10.1210/clinem/dgac657.