SynthesisEuropean journal of cancer (Oxford, England : 1990)2015
Characterisation of liver chemistry abnormalities associated with pazopanib monotherapy: a systematic review and meta-analysis of clinical trials in advanced cancer patients.
Synthesis in European journal of cancer (Oxford, England : 1990), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 50 citations in OpenAlex.
- A Phase I/II Study to Assess the Safety and Efficacy of Pazopanib and Pembrolizumab Combination Therapy in Patients with Advanced Renal Cell Carcinoma.Clinical genitourinary cancer · 2021Trial
- Outcomes based on prior therapy in the phase 3 METEOR trial of cabozantinib versus everolimus in advanced renal cell carcinoma.British journal of cancer · 2018Trial
- The impact of pazopanib and extremity radiotherapy on transaminase elevations in soft tissue sarcoma.Acta oncologica (Stockholm, Sweden) · 2026Article
- IQ DILI Consensus Opinion: Best Practices for Rechallenge Following Suspected Drug-Induced Liver Injury in Clinical Trials.Drug safety · 2025Article
- Systematic Evaluation of Tyrosine Kinase Inhibitors as OATP1B1 Substrates Using a Competitive Counterflow Screen.Cancer research communications · 2024Article
- Beyond the Checkpoint: Severe Axitinib-induced Liver Injury.ACG case reports journal · 2023Article
- Association between pazopanib exposure and safety in Japanese patients with renal cell carcinoma or soft tissue sarcoma.Scientific reports · 2023Article
- Pazopanib-Induced Liver Injury in Patients With Metastatic Renal Cell Carcinoma: A Report of Two Cases.Cureus · 2022Article
- Severe tyrosine-kinase inhibitor induced liver injury in metastatic renal cell carcinoma patients: two case reports assessed for causality using the updated RUCAM and review of the literature.BMC gastroenterology · 2022Review
- Overview of Causality Assessment for Drug-Induced Liver Injury (DILI) in Clinical Trials.Drug safety · 2021Review
- Drug-induced liver injury: Asia Pacific Association of Study of Liver consensus guidelines.Hepatology international · 2021Article
- Review
- Pazopanib-induced mixed liver injury in a patient with soft-tissue sarcoma, but without the UGT1A1*28 mutation: a case report.Clinical journal of gastroenterology · 2021Article
- Clinical implications of drug-induced liver injury in early-phase oncology clinical trials.Cancer · 2020Article
- Pazopanib-associated interstitial lung disease in a patient with renal cell carcinoma.BMJ case reports · 2020Article
- Delayed nivolumab-induced hepatotoxicity during pazopanib treatment for metastatic renal cell carcinoma: An autopsy case.IJU case reports · 2019Article
- External validation of nomograms for prediction of progression-free survival and liver toxicity in patients with advanced renal cell carcinoma treated with pazopanib.International journal of clinical oncology · 2019Article
- The Current and Evolving Landscape of First-Line Treatments for Advanced Renal Cell Carcinoma.The oncologist · 2019Review
- Relative Dose Intensity of Induction-Phase Pazopanib Treatment of Soft Tissue Sarcoma: Its Relationship with Prognoses of Pazopanib Responders.Journal of clinical medicine · 2019Article
- Review
Corrections and comments
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Authors and funding
11 authors at 8 institutions in 4 countries.
Funding
Abstract
Drug-induced liver chemistry abnormalities, primarily transaminase elevations, are commonly observed in pazopanib-treated patients. This meta-analysis characterises liver chemistry abnormalities associated with pazopanib. Data of pazopanib-treated patients from nine prospective trials were integrated (N=2080). Laboratory datasets were used to characterise the incidence, timing, recovery and patterns of liver events, and subsequent rechallenge with pazopanib. Severe cases of liver chemistry abnormalities were clinically reviewed. Multivariate analyses identified predisposing factors. Twenty percent of patients developed elevated alanine aminotransferase (ALT) >3×ULN. Incidence of peak ALT >3-5×ULN, >5-8×ULN, >8-20×ULN and >20×ULN was 8%, 5%, 5% and 1%, respectively. Median time to onset for all events was 42days; 91% of events were observed within 18weeks. Recovery rates based on peak ALT >3-5×ULN, >5-8×ULN, >8-20×ULN and >20×ULN were 91%, 90%, 90% and 64%, respectively. Median time from onset to recovery was 30days, but longer in patients without dose interruption. Based on clinical review, no deaths were associated with drug-induced liver injury. Overall, 38% of rechallenged patients had ALT elevation recurrence, with 9-day median time to recurrence. Multivariate analysis showed that older age was associated with development of ALT >8×ULN. There was no correlation between hypertension and transaminitis. Our data support the current guidelines on regular liver chemistry tests after initiation of pazopanib, especially during the first 9 or 10weeks, and also demonstrate the safety of rechallenge with pazopanib.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.