Hand-foot skin reaction with vascular endothelial growth factor receptor tyrosine kinase inhibitors in cancer patients: A systematic review and meta-analysis

•This meta-analysis provided a comprehensive evaluation of HFSR in patients with cancers receiving VEGFR-TKIs.•VEGFR-TKIs significantly increase the risk of developing HFSR in cancer patients.•The risk of all-grade HFSR varies significantly according to tumor type.•The risk of all-grade and high-grade HFSR did not affect by drug types, treatment line, median age and treatment duration.

A meta-analysis was conducted to systematically review the risk of hand-foot skin reaction (HFSR) with vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) in patients with cancer. The relevant studies of the randomized controlled trials (RCTs) in cancer patients treated with VEGFR-TKIs were retrieved and the systematic evaluation was conducted. EMBASE, MEDLINE, and PubMed were searched for articles published till May 2017. Twenty-one RCTs and 9552 patients were included. The current analysis suggested that the use of VEGFR-TKIs increased the risk of all-grade HFSR (7.04;95%CI, 5.33-9.30;p < 0.00001) and high-grade (≥grade 3) HFSR (21.62;95%CI, 15.19-30.78;p < 0.00001). On subgroup analyses, the risk ratio (RR) of all-grade HFSR varies significantly according to cancer type, whereas the RR of high-grade HFSR did not. The risk of all-grade and high-grade HFSR did not affect by drug types, treatment line, median age and treatment duration.