Correlation Between Drug-Induced Blood Pressure Elevation and Long-Term Prognosis of Tumor Patients Treated With Small Molecule Tyrosine Kinase Inhibitors Targeted to the Vascular Endothelial Growth Factor Pathway: A Meta-analysis
Bibliographic record
Abstract
Abstract OBJECTIVE To evaluate whether blood pressure elevation induced by small molecule tyrosine kinase inhibitors (TKIs) targeted to the vascular endothelial growth factor pathway in the treatment of solid tumors is correlated with the anti-tumor efficacy and long-term prognosis. METHODS A systematic review with a meta-analysis was conducted using Cochrane Collaboration methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Grading of Recommendations Assessment, Development, and Evaluation guidelines. Observational, retrospective, or prospective randomized controlled studies were included if they evaluated the correlation between TKIs-induced blood pressure elevation and prognosis of patients, with at least one of the following indicators: objective response rate (ORR), progression-free survival (PFS), or overall survival (OS). Data were extracted and all studies were assessed for quality according to the Newcastle-Ottawa Scale. The primary outcome of this study was OS, while the secondary outcomes were PFS and ORR. RESULTS A total of 58 studies were considered eligible, with 10,020 patients included. TKIs-induced blood pressure elevation was significantly correlated with longer OS [the hazards ratio (HR) was 0.54 (95% confidence interval [CI] 0.49–0.61, P < 0.001) for death in patients with elevated blood pressure compared with those without], and PFS [HR was 0.55 (95% CI 0.48–0.63, P < 0.001) for disease progression in patients with elevated blood pressure compared with those without], as well as better ORR (RR = 1.86, 95% CI 1.43–2.41, P < 0.001). The subgroup analyses by intervention drugs and tumor types had similar results. CONCLUSIONS TKIs-induced blood pressure elevation is significantly correlated with better prognosis of tumor patients, thereby it may be one of the biological markers of TKI treatment. However, due to the considerable heterogeneity among the included studies in this article, caution should be exercised in interpreting this conclusion.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.016 | 0.033 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.017 | 0.055 |
| Bibliometrics | 0.004 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".