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Meta-Analysis
. 2017 Feb 7;8(6):10703-10713.
doi: 10.18632/oncotarget.12926.

Bevacizumab combined with chemotherapy for ovarian cancer: an updated systematic review and meta-analysis of randomized controlled trials

Yu Shen Wu  1 , Lin Shui  1 , Dan Shen  1 , Xiaopin Chen  1
Affiliations
Meta-Analysis

Bevacizumab combined with chemotherapy for ovarian cancer: an updated systematic review and meta-analysis of randomized controlled trials

Yu Shen Wu et al. Oncotarget. .

Abstract

Background: This meta-analysis was updated with results from a new trial and final data to reassess the efficacy and safety of bevacizumab combined with chemotherapy in ovarian cancer (OC).

Methods: Randomized controlled trials (RCTs) were searched in PubMed, EMBASE, Cochrane clinical trials, Web of Science and clinicaltrial.gov databases. Outcomes included the progression-free survival (PFS), overall survival (OS), objective response rate (ORR) and common adverse events. The hazard ratio (HR), risk ratio (RR) and odds ratio (OR) were pooled when the meta-analysis was performed.

Results: Five RCTs with 4994 patients were included. In overall newly diagnosed OC, bevacizumab combined with chemotherapy did not significantly improve PFS (HR 0.85, 95%CI 0.70-1.02) or OS (HR 0.94, 95%CI 0.84-1.05). In the high-risk progression subgroup, the addition of bevacizumab significantly improved PFS (HR 0.76, 95%CI 0.68-0.84) and OS (HR 0.85, 95%CI 0.74-0.96). In recurrent OC, the addition of bevacizumab to chemotherapy significantly extended PFS (HR 0.53, 95%CI 0.45-0.63) and OS (HR 0.87, 95%CI 0.77-0.99). The ORR was improved (OR 2.37, 95%CI 1.99-2.82) in the overall population. Bevacizumab increased the incidence of hypertension (RR 21.27, 95%CI 9.42-48.02), proteinuria (RR 4.77, 95%CI 2.15-10.61), bleeding (RR 3.16, 95%CI 1.59-6.30), GI perforations (RR 2.76, 95%CI 1.51-5.03), arterial thrombosis events (RR 2.39, 95%CI 1.39-4.10) and venous thrombosis events (RR 1.43, 95%CI 1.04-1.96).

Conclusions: Bevacizumab combined with chemotherapy significantly improved PFS and OS in both patients with high-risk of progression and patients with recurrent OC, with an increased incidence of common adverse events. However, no statistically significant survival benefit was identified in the front-line settings.

Keywords: adverse event; bevacizumab; meta-analysis; ovarian cancer; survival.

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Conflict of interest statement

CONFLICTS OF INTEREST

All authors claimed no competing interests.

Figures

Figure 1
Figure 1. The process of study selection
Figure 2
Figure 2. Risk of bias summary
Figure 3
Figure 3. Forest plots for PFS
Figure 4
Figure 4. Forest plot for OS
Figure 5
Figure 5. Forest plots for ORR
Figure 6
Figure 6. Forest plot for common adverse events
Figure 7
Figure 7. Funnel plot
See this image and copyright information in PMC

References

    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin. 2015;65:5–29. doi: 10.3322/caac.21254. - DOI - PubMed
    1. Gonzalez Martin A, Bratos R, Marquez R, Alonso S, Chiva L. Bevacizumab as front-line treatment for newly diagnosed epithelial cancer. Expert Rev Anticancer Ther. 2013;13:123–9. doi: 10.1586/era.12.165. - DOI - PubMed
    1. Ramakrishnan S, Subramanian IV, Yokoyama Y, Geller M. Angiogenesis in normal and neoplastic ovaries. Angiogenesis. 2005;8:169–82. doi: 10.1007/s10456-005-9001-1. - DOI - PubMed
    1. Perren TJ, Swart AM, Pfisterer J, Ledermann JA, Pujade-Lauraine E, Kristensen G, Carey MS, Beale P, Cervantes A, Kurzeder C, du Bois A, Sehouli J, Kimmig R, et al. A phase 3 trial of bevacizumab in ovarian cancer. N Engl J Med. 2011;365:2484–96. doi: 10.1056/NEJMoa1103799. - DOI - PubMed
    1. Colemana MFB R.L., Brady M.F., Herzog T.J., Sabbatini P., Armstrong D.K., Walker J.L., Kim B.G., Fujiwara K., Tewari K.S., O’Malley D.M. A phase III randomized controlled clinical trial of carboplatin and paclitaxel alone or incombination with bevacizumab followed by bevacizumab and secondary cytoreductive surgery in platinum-sensitive, recurrent ovarian, peritoneal primary and fallopian tube cancer (Gynecologic Oncology Group 0213). Presented at: Society of Gynecologic Oncology 2015 Annual Meeting on Women's Cancer; March 28–31, 2015; Chicago, Illinois. Abstract. 3 doi: 10.1016/j.ygyno.2015.01.005. - DOI

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