Department of Medicine, Stony Brook University School of Medicine, NY, USA.
Acta Oncol. 2011 Oct;50(7):997-1005. doi: 10.3109/0284186X.2011.581689. Epub 2011 May 9.
Vascular endothelial growth factor (VEGF) may play a role in erythropoiesis. We performed a meta-analysis of randomized controlled trials (RCT) to determine the effect of the anti-VEGF antibody bevacizumab on anemia in cancer patients treated with chemotherapy.
Databases from PUBMED, the Web of Science, Embase, the Cochrane Library, and abstracts presented at the American Society of Clinical Oncology (ASCO) conferences until May 2010 were searched to identify relevant studies. Eligible studies included prospective RCTs in which the combination of bevacizumab and chemotherapy was compared with chemotherapy alone. Summary incidence rate, relative risk (RR), and 95% confidence interval (CI) were calculated.
A total of 6439 patients with a variety of solid tumors were included for analysis from 11 RCTs. Among those patients receiving bevacizumab and chemotherapy, the incidences of all-grade and high-grade (grade 3 and above) anemia were 17.8% (95% CI: 11.1-27.1%) and 2.8% (95% CI: 1.6-5.0%) respectively. In comparison with chemotherapy alone, bevacizumab significantly reduced all-grade (RR, 0.79; 95% CI: 0.66-1.0, p = 0.007) and high-grade anemia (RR, 0.72; 95% CI: 0.57-0.90, p = 0.005). The effect did not vary significantly among bevacizumab doses (p = 0.88), tumor types (p = 0.75) or chemotherapy regimens (p = 0.98).
Bevacizumab may significantly reduce the risk of anemia with chemotherapy in cancer patients.
血管内皮生长因子（VEGF）可能在红细胞生成中发挥作用。我们进行了一项荟萃分析，以确定抗血管内皮生长因子抗体贝伐单抗对接受化疗的癌症患者贫血的影响。
检索了 PUBMED、Web of Science、Embase、Cochrane 图书馆数据库，以及截至 2010 年 5 月在美国临床肿瘤学会（ASCO）会议上提交的摘要，以确定相关研究。合格的研究包括将贝伐单抗联合化疗与单独化疗进行比较的前瞻性 RCT。计算了综合发生率、相对风险（RR）和 95%置信区间（CI）。
共有 11 项 RCT 分析了 6439 例不同实体瘤患者。在接受贝伐单抗联合化疗的患者中，所有级别和高级别（3 级及以上）贫血的发生率分别为 17.8%（95%CI：11.1-27.1%）和 2.8%（95%CI：1.6-5.0%）。与单独化疗相比，贝伐单抗显著降低了所有级别（RR，0.79；95%CI：0.66-1.0，p=0.007）和高级别贫血（RR，0.72；95%CI：0.57-0.90，p=0.005）。贝伐单抗剂量（p=0.88）、肿瘤类型（p=0.75）或化疗方案（p=0.98）之间的效果无显著差异。
贝伐单抗可能显著降低癌症患者化疗引起的贫血风险。
