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Patients with advanced non-small cell lung cancer who were receiving Vandetanib: risk of hypertension and QTc prolongation


A meta-analysis of published data was conducted to investigate the overall risks of hypertension and QTc prolongation in patients with advanced non-small cell lung cancer ( NSCLC ) who were receiving Vandetanib ( Caprelsa ).

A search was performed to obtain eligible randomized controlled trials ( RCTs ) that compared hypertension and/or QTc prolongation profile of Vandetanib alone or plus chemotherapy with control groups ( placebo, single targeted therapy, chemotherapy, or a combination of them ) in patients with advanced non-small cell lung cancer.

The outcome measures were the overall risks of hypertension and QTc prolongation.

A total of nine RCTs, which involved 4813 patients, were enrolled in the present study.

A significant increase in risk was observed for all-grade hypertension ( RR=5.58; 95 % CI 4.16 to 7.48; P less than  0.00001 ) and grade greater than or equal to 3 hypertension ( RR=4.79; 95 % CI 2.31 to 9.93; P  less than  0.0001 ) in advanced NSCLC patients who were receiving Vandetanib compared with the controls.

Moreover, Vandetanib significantly prolonged all-grade QTc interval ( RR=7.90; 95 % CI 4.03 to 15.50; P  less than  0.00001) and grade greater than or equal to 3 QTc interval ( RR=3.12; 95 % CI 1.01 to 9.63; P = 0.05 ).

In conclusion, current evidence has shown that significant risks in developing hypertension and QTc prolongation exist in advanced NSCLC patients who were receiving Vandetanib.
Thus, appropriate monitoring and management of these events are recommended. ( Xagena )

Liu Y et al, Eur J Clin Pharmacol 2015; Epub ahead of print

XagenaMedicine_2015



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