Wang Yizi, Zhang Shitai, Song Zixuan, Ouyang Ling, Li Yan
Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
Front Pharmacol. 2021 Nov 17;12:726278. doi: 10.3389/fphar.2021.726278. eCollection 2021.
Anti-angiogenesis agents have been added as maintenance therapy in ovarian cancer over the past decade. The aim of this meta-analysis was to analyze the efficacy of anti-angiogenesis therapy in newly diagnosed and relapsed ovarian cancer. PubMed, Embase, and Cochrane databases were searched for all phase III randomized controlled trials (RCTs) that assessed the efficacy and toxicity of anti-angiogenesis agents in ovarian cancer. Overall survival (OS) and progression-free survival (PFS) were used to evaluate the effectiveness of anti-angiogenesis therapy in ovarian cancer. A total of 6097 patients with newly diagnosed ovarian cancer from 5 phase III RCTs and 2943 patients with relapsed ovarian cancer from 6 phase III RCTs were included in this meta-analysis. The pooled results showed that anti-angiogenesis maintenance therapy significantly improved PFS (hazard ratio [HR], 0.84; 95% confidence interval [CI], 0.76-0.93; = 0.001), but not OS (HR, 0.98; 95% CI, 0.91-1.05; = 0.49) compared with placebo in patients with newly diagnosed ovarian cancer. In patients with relapsed ovarian cancer, the pooled results showed a significant improvement on OS (HR, 0.89; 95% CI, 0.82-0.98; = 0.02) and PFS (HR, 0.61; 95% CI, 0.52-0.72; < 0.001). The pooled results also showed that the anti-angiogenesis agents were associated with an increase in the occurrence of severe hypertension, neutropenia, diarrhea, thrombocytopenia, headache, and bleeding in ovarian cancer. However, infrequent fatal adverse events occurred in the anti-angiogenesis groups. Study results suggest that anti-angiogenesis agents were an effective therapy for newly diagnosed and relapsed ovarian cancer, especially for relapsed ovarian cancer. Anti-angiogenesis agents may be associated with some severe but not fatal adverse events. https://www.crd.york.ac.uk/prospero/, identifier CRD42021283647.
在过去十年中，抗血管生成药物已被添加到卵巢癌的维持治疗中。本荟萃分析的目的是分析抗血管生成疗法在新诊断和复发卵巢癌中的疗效。检索了PubMed、Embase和Cochrane数据库，以查找所有评估抗血管生成药物在卵巢癌中的疗效和毒性的III期随机对照试验（RCT）。总生存期（OS）和无进展生存期（PFS）用于评估抗血管生成疗法在卵巢癌中的有效性。本荟萃分析纳入了来自5项III期RCT的6097例新诊断卵巢癌患者和来自6项III期RCT的2943例复发卵巢癌患者。汇总结果显示，与安慰剂相比，抗血管生成维持疗法在新诊断卵巢癌患者中显著改善了PFS（风险比[HR]，0.84；95%置信区间[CI]，0.76 - 0.93；P = 0.001），但未改善OS（HR，0.98；95%CI，0.91 - 1.05；P = 0.49）。在复发卵巢癌患者中，汇总结果显示OS（HR，0.89；95%CI，0.82 - 0.98；P = 0.02）和PFS（HR，0.61；95%CI，0.52 - 0.72；P < 0.001）有显著改善。汇总结果还显示，抗血管生成药物与卵巢癌中严重高血压、中性粒细胞减少、腹泻、血小板减少、头痛和出血的发生率增加有关。然而，抗血管生成药物组发生的致命不良事件很少。研究结果表明，抗血管生成药物是新诊断和复发卵巢癌的有效治疗方法，尤其是对复发卵巢癌。抗血管生成药物可能与一些严重但非致命的不良事件有关。https://www.crd.york.ac.uk/prospero/，标识符CRD42021283647。
