BACKGROUND AND AIM: Selumetinib is a promising and interesting targeted therapy 
agent as it may reverse radioiodine uptake in patients with 
radioiodine-refractory differentiated thyroid cancer. We conduct this meta- 
analysis to compare the efficacy and safety of selumetinib with current 
therapies in patients with advanced cancer.
METHODS: An electronic search was conducted using PubMed/ Medicine, EMBASE and 
Cochrane library databases. Statistical analyses were carried out using either 
random-effects or fixed-effects models according to the heterogeneity of 
eligible studies.
RESULTS: Six eligible trials involved 601 patients were identified. Compared 
with current therapies, treatment schedules with selumetinib did not improve 
progression free survival (hazard ratio, 0.91; 95%CI 0.70-1.17, P= 0.448), but 
did identify better clinical benefits (odds ratio, 1.24; 95%CI 0.69- 2.24, P = 
0.472) and less disease progression (hazard ratio, 0.72; 95%CI 0.51-1.00, P = 
0.052) though its impact was not statistically significant. Sub-group analysis 
resulted in significantly improved progression free survival (hazard ratio, 
0.61; 95%CI 0.49-0.57, P = 0.00), clinical benefits (odds ratio, 3.04; 95%CI 
1.60-5.77, P = 0.001) and reduced disease progression (hazard ratio, 0.35; 95%CI 
0.18-0.67, P = 0.001) in patients administrated selumetinib. Dermatitis 
acneiform (risk ratio, 9.775; 95%CI 3.143-30.395, P = 0.00) and peripheral edema 
(risk ratio, 2.371; 95%CI 1.690-3.327, P = 0.00) are the most frequently 
observed adverse effects associated with selumetinib.
CONCLUSIONS: Compared with current chemotherapy, selumetinib has modest clinical 
activity as monotherapy in patients with advanced cancer, but combinations of 
selumetinib with cytotoxic agents in patients with BRAF or KRAS mutations hold 
great promise for cancer treatment. Dermatitis acneiform and peripheral edema 
are the most frequently observed adverse effects in patients with selumetinib.