Cardiovascular Toxicity Risks of Sunitinib in Cancer Patients: A Meta-Analysis

Abstract

Background: At present, no research has systematically integrated existing data to assess the risks of cardiovascular toxicity caused by sunitinib. The goal of this study was to evaluate the risks of cardiovascular toxicity in patients with cancer who were taking sunitinib. Methods: Randomized controlled trials which used sunitinib to treat cancer patients and were published before 15 November 2021, were searched in Embase, Web of Science, and PubMed. Outcomes included cardiovascular toxicities such as hypertension, bleeding, and thromboembolism. Meta-analysis was performed using Stata (15.0, STATA Corp., College Station, TX, USA). Results: Eleven studies encompassing 5875 patients were included. Use of sunitinib was found to increase cardiovascular toxicity in patients, including all-grade hypertension (RR (relative risk) = 4.74, 95% CI 3.24–6.92), high-grade hypertension (RR = 4.13, 95% CI 2.95–5.76), and all-grade bleeding (RR = 3.16, 95% CI 2.38–4.20). However, sunitinib did not increase risks of all-grade thromboembolism in cancer patients compared to controls (RR = 1.45, 95% CI 0.44–4.79). Conclusions: This meta-analysis showed that use of sunitinib increases cardiovascular toxicity in patients with cancer. Doctors should understand these clinical risks and regularly perform cardiovascular monitoring.