Risk of mucocutaneous toxicities in patients with solid tumors treated with sunitinib: a critical review and meta analysis

Introduction: we performed a systematic review and meta-analysis of mucocutaneous toxicities associatedwith sunitinib, an oral multi-tyrosine kinase inhibitor. Methods: eligible studies included randomized Phase II and III trials of patients with solid tumors on sunitinib daily, describing events of hand-foot syndrome, skin rash, stomatitis, and skin and hair discoloration. Results: the relative risk (RR) of all-grade hand-foot skin reaction, skin rash, stomatitis, skin and hair discoloration were 2.12 (95% CI: 1.28-3.51; p < 0.004), 1.33 (95% CI: 1.15-1.54; p < 0.0002), 1.88 (95% CI: 1.36-2.59; p = 0.0001), 16.6 (95% CI: 4.18-64.94 p < 0.003), 4.42 (95% CI: 0.8-24.5; p < 0.09); respectively. Conclusions: our meta-analysis has demonstrated that sunitinib is associated with a higher risk of developing all-grade hand-foot skin reaction, skin rash, stomatitis and skin discoloration compared with control. Clinicians should be aware of these risks and perform regular clinical monitoring.