mTOR inhibitors and risk of ovarian cysts: a systematic review and meta-analysis.

Abstract

OBJECTIVE:

To summarise the available evidence on frequency of ovarian cyst development during mammalian target of rapamycin inhibitors (mTORi) treatment.

METHODS:

PubMed/Medline and EMBASE databases were searched, from 1990 up to March 2020, using the following keywords: 'tacrolimus', 'sirolimus', 'temsirolimus', 'everolimus', 'deforolimus', 'mTOR' and 'ovarian cysts' (Limit: Human, English, full article). Studies were selected for the review if they met the following criteria: clinical studies, studies reporting original data, studies reporting the number of patients using mTORi, studies reporting the number of patients with ovarian cysts.We selected 7 of 20 retrieved studies. Study design, population, sample size, criteria for diagnosis of ovarian cysts, drug doses and follow-up length were extracted. Pooled estimate of incidence was calculated for ovarian cysts as a percentage, with 95% CI.

RESULTS:

Four hundred-six women were included in the selected studies. The pooled incidence was 37.0% (95% CI 16.0% to 58.1%) for all ovarian cysts, and 17.3% (95% CI 5.6% to 29.1%) for clinically significant ovarian cysts. Based on two articles, comparing mTORi and non-mTORi for immunosuppression, pooled OR for ovarian cyst incidence was 4.62 (95% CI 2.58 to 8.28).

CONCLUSION:

Ovarian cyst development is a common adverse event during immunosuppression treatment with mTORi. These cysts are benign conditions, but they require pelvic ultrasound follow-up and in some cases hospital admission and surgery.

• Authors: Fabio Parazzini, Sandro Gerli, Alessandro Favilli, Michele Vignali, Elena Ricci, Sonia Cipriani, Francesca Chiaffarino, Andrea Dell'acqua, Sergio Harari, Stefano Bianchi
• Journal: BMJ open (BMJ Open) Vol. 11 Issue 9 Pg. e048190 (09 24 2021) ISSN: 2044-6055 [Electronic] England
• PMID: 34561260 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)
• Copyright: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• Everolimus
• MTOR protein, human
• TOR Serine-Threonine Kinases

Topics

• Everolimus
• Female
• Humans
• Incidence
• Ovarian Cysts (chemically induced, epidemiology)
• Pelvis
• TOR Serine-Threonine Kinases