Risk of hematologic toxicities in patients with solid tumors treated with everolimus: A systematic review and meta-analysis

We performed a systematic review and meta-analysis of hematologic toxicities associated with everolimus, an oral mammalian target of rapamycin (mTOR) inhibitor. Eligible studies included phase II and III trials of patients with solid tumors on 10 mg of everolimus daily describing events of neutropenia, thrombocytopenia, anemia or lymphopenia. The incidence of everolimus-associated all-grade and high-grade (Grade 3–4) hematologic toxicities were, respectively: neutropenia: 21.7% and 3.6%; thrombocytopenia: 36.0% and 4.7%; anemia: 61.2% and 8.4% and lymphopenia: 40.9% and 14.9%. Everolimus was associated with an increased risk of all-grade neutropenia (RR = 2.24, [95% CI 1.51–3.32]), all-grade (RR = 9.19, [95% CI 4.51–18.70]) and high-grade (RR = 7.46, [95% CI 2.58–21.61]) thrombocytopenia, all-grade (RR = 1.58, [95% CI 1.25–1.99]) and high-grade (RR = 3.92, [95% CI 1.46–10.52]) anemia and all-grade (RR = 1.72, [95% CI 1.50–1.97]) and high-grade (RR = 2.70, [95% CI 1.86–3.93]) lymphopenia.