Meta-analysis of therapeutic effects and the risks of hypertension and hyperglycemia in patients with renal cell carcinoma who were receiving antiangiogenic drugs.

PURPOSE: A meta-analysis of published data was conducted to investigate the therapeutic effects in patients with renal cell carcinoma (RCC) who were receiving antiangiogenic drugs.

METHODS: A computerized search through electronic databases, including PubMed (until February 2016), was performed to obtain eligible randomized controlled trials that compared the effectiveness of antiangiogenic with control groups (everolimus, placebo, and interferon [IFN] alfa) in patients with RCC. The data of progressive disease, objective response rate (ORR), stable disease rate (SDR), progressive disease rate (PDR), progression-free survival (PFS), and overall survival (OS) were extracted to assess therapeutic effects, hypertension, and hyperglycemia. Relative risk and 95% confidence interval were calculated and pooled using a fixed effects model.

RESULTS: According to the meta-analysis, antiangiogenic agents have advantages in ORR (odds ratio [OR] =2.93, P < 0.00001), SDR (OR = 1.45, P < 0.00001), PDR (OR = 0.25, P < 0.00001, PFS (OR = 0.65, P < 0.00001), and median OS (OR = 0.88, P < 0.00001) compared with control group; in the subway group, sorafenib and pazopanib have advantages in median PFS compared with placebo (OR = 0.52, P < 0.00001); sunitinib and pazopanib have advantages in median OS compared with IFN (OR = 0.87, P = 0.03). Sunitinib, sorafenib, and pazopanib have greater risk of hypertension compared with control group (OR = 8.40, P < 0.00001); sunitinib and pazopanib did not have greater risk of hypertension compared with control group (OR = 1.26, P = 0.25).

CONCLUSIONS: Sorafenib, sunitinib, and the combination of bevacizumab and IFN are more effective in stabilizing disease, but they have higher risk of hypertension.