Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa 3109601, Israel.
Curr Oncol. 2023 Sep 3;30(9):8159-8171. doi: 10.3390/curroncol30090592.
Serous epithelial ovarian cancer, classified as either high-grade (90%) or low-grade (10%), varies in molecular, histological, and clinicopathological presentation. Low-grade serous ovarian cancer (LGSOC) is a rare histologic subtype that lacks disease-specific evidence-based treatment regimens. However, LGSOC is relatively chemo-resistant and has a poor response to traditional treatments. Alternative treatments, including biologic therapies such as bevacizumab, have shown some activity in LGSOC. Thus, the objective of this systematic review is to determine the effect and safety of bevacizumab in the treatment of LGSOC. Following PRISMA guidelines, Medline ALL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Embase all from the OvidSP platform, ClinicalTrials.gov, International Clinical Trials Registry Platform, International Standard Randomised Controlled Trial Number Registry were searched from inception to February 2022. Articles describing bevacizumab use in patients with LGSOC were included. Article screening, data extraction, and critical appraisal of included studies were completed by two independent reviewers. The effect of bevacizumab on the overall response rate, progression-free survival, overall survival, and adverse effects were summarized. The literature search identified 3064 articles, 6 of which were included in this study. A total of 153 patients were analyzed; the majority had stage IIIC cancer (56.2%). The overall median response rate reported in the studies was 47.5%. Overall, bevacizumab is a promising treatment for LGSOC, with response rates higher than traditional treatment modalities such as conventional chemotherapy, and is often overlooked as a treatment tool. A prospective clinical trial evaluating the use of bevacizumab in LGSOC is necessary to provide greater evidence and support these findings.
浆液性上皮性卵巢癌分为高级别(90%)和低级别(10%),在分子、组织学和临床病理表现上存在差异。低级别浆液性卵巢癌(LGSOC)是一种罕见的组织学亚型,缺乏针对该疾病的基于证据的治疗方案。然而,LGSOC 相对化疗耐药,对传统治疗的反应较差。替代治疗方法,包括贝伐珠单抗等生物疗法,在 LGSOC 中显示出一定的活性。因此,本系统评价的目的是确定贝伐珠单抗在治疗 LGSOC 中的疗效和安全性。根据 PRISMA 指南,从 OvidSP 平台上的 Medline ALL、Cochrane 中央对照试验注册库、Cochrane 系统评价数据库、Embase 以及 ClinicalTrials.gov、国际临床试验注册平台、国际标准随机对照试验编号注册库中搜索了从开始到 2022 年 2 月的文献。纳入了描述贝伐珠单抗在 LGSOC 患者中应用的文章。由两名独立评审员完成文章筛选、数据提取和纳入研究的批判性评价。总结了贝伐珠单抗对总缓解率、无进展生存期、总生存期和不良反应的影响。文献检索共确定了 3064 篇文章,其中 6 篇纳入本研究。共有 153 例患者纳入分析;大多数患者为 IIIC 期癌症(56.2%)。研究报告的总体中位缓解率为 47.5%。总体而言,贝伐珠单抗是 LGSOC 的一种有前途的治疗方法,其缓解率高于传统治疗方法,如常规化疗,并且常常被忽视为一种治疗工具。有必要进行一项前瞻性临床试验,以评估贝伐珠单抗在 LGSOC 中的应用,以提供更多的证据支持这些发现。