The following is a summary of “Higher risk of hepatotoxicity associated with cabozantinib in cancer patients,” published in the February 2024 issue of Oncology by Wang et al.
The growing interest in cabozantinib across various solid tumors underscores the need to assess its associated hepatotoxicity risk in cancer patients. In this study, the study group conducted a comprehensive evaluation aimed at determining the likelihood of hepatotoxic events linked to cabozantinib treatment.
Their methodology involved a thorough search of PubMed, Cochrane, and EMBASE databases for randomized controlled trials (RCTs) published from inception until September 9, 2023. Key outcomes examined included all-grade and grade ≥3 elevations in aspartate aminotransferase (AST) and alanine aminotransferase (ALT), with relative risk (RR) and 95% CI serving as the primary analytical metrics. A total of 922 records were screened, ultimately identifying 8 RCTs encompassing 2613 cancer patients for inclusion in the analysis. The results revealed a heightened risk of hepatotoxicity associated with cabozantinib administration, with patients receiving this treatment exhibiting significantly elevated relative risks for all-grade AST elevation (RR, 2.63; 95% CI, 2.16-3.20, P < 0.001), all-grade ALT elevation (RR, 2.89; 95% CI, 2.31-3.60, P < 0.001), grade ≥3 AST elevation (RR, 2.26; 95% CI, 1.34-3.83, P = 0.002), and grade ≥3 ALT elevation (RR, 3.40; 95% CI, 1.65-7.01, P < 0.001) compared to those not receiving cabozantinib. Subgroup analyses further underscored that the risk of hepatotoxicity associated with cabozantinib surpassed that observed with other tyrosine kinase inhibitors (TKIs) such as erlotinib, sunitinib, and sorafenib, as well as non-TKI drugs, including everolimus, prednisone, mitoxantrone, and paclitaxel.
In conclusion, the findings elucidate a higher risk of hepatotoxicity associated with cabozantinib compared to other commonly used solid tumor drugs. This underscores the importance of vigilant monitoring and risk assessment when considering cabozantinib therapy in cancer patients.
Source: sciencedirect.com/science/article/abs/pii/S1040842824000416