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Increased risk of hyperglycemia associated with the use of everolimus in patients with cancer: a systematic review and meta-analysis
Authors:Zihan Guo  Yuanyuan Jiao  Zhanmiao Yi  Ran Li  Yanhua Zhang
Abstract:Everolimus is an orally administered rapamycin analogue that has been approved to treat several types of solid tumors. However, some patients develop hyperglycemia after being treated with everolimus. In this meta-analysis, we aimed to evaluate the incidence and risk of hyperglycemia in patients with cancer who received everolimus. We searched the medical literature, as index in the Cochrane Library, PubMed, EMBASE, and abstracts from the top scientific meetings (AACR, ASCO, and ESMO). Our meta-analysis included the randomly controlled trials published before November 2014. We calculated overall incidence, relative risk (RR) and 95% confidence intervals (CI) using fixed-effects or random-effects models, depending on the heterogeneity among the trials. A total of 3377 patients (everolimus: 1971; control: 1406) from 8 randomized clinical trials were included in the meta-analysis. In the everolimus groups, the incidence of all grades of hyperglycemia was 20.0% (95% CI: 11.0%–29.0%), while the incidence of high-grade hyperglycemia was 6.0% (95% CI: 3.0%–8.0%). Patients treated with everolimus had an increased risk of hyperglycemia as compared with that of controls (all-grade RR: 2.94, 95% CI: 2.34–3.70; high-grade RR: 4.66, 95% CI: 2.75–7.89). Everolimus significantly increased the risk of hyperglycemia. This risk may depend on the tumor type and the everolimus dosage.
Keywords:Everolimus  Hyperglycemia  Tumor type  Dosage  Meta-analysis  
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