Department of Medicine, Services Institute of Medical Sciences.
Department of Medicine, Allama Iqbal Medical College.
Am J Clin Oncol. 2024 Aug 1;47(8):399-408. doi: 10.1097/COC.0000000000001100. Epub 2024 Jun 21.
This systematic review and meta-analysis aims to evaluate the efficacy and safety of bevacizumab in patients with ovarian cancer over a shorter and longer follow-up period.
We searched Medline, Cochrane CENTRAL, Scopus, and Google Scholar for all phase 3 randomized controlled trials (RCTs) that administered bevacizumab to women with ovarian cancer. Review Manager 5.4 was used to calculate risk ratios (RR) and hazard ratios (HR) with 95% CIs. We assessed the quality of the included studies using version 2 of the Cochrane Risk of Bias tool (RoB 2).
After screening the titles, abstracts, and full texts, we included nine RCTs in our systematic review and meta-analysis. Four RCTs had a low risk of bias, while 5 had some concerns. Bevacizumab was associated with a progression free survival benefit for <36 months (HR: 0.59, 95% CI: 0.45-0.76, P <0.0001, I2 =90%) and >36 months (HR: 0.66, 95% CI: 0.55-0.80, P <0.0001, I2 =80%), and an overall survival benefit for <36 months (HR: 0.87, 95% CI: 0.78-0.98, P =0.02, I2 =0%) but not for >36 months (HR: 0.98, 95% CI: 0.89-1.09, P =0.77, I2 =30%). There was no difference in deaths between intervention and control groups <36 months (RR: 0.95, 95% CI: 0.86-1.04, P =0.26, I2 =10%) or >36 months (RR: 1.02, 95% CI: 0.97-1.06, P =0.50, I2 =0%). Bevacizumab reduced disease progression <36 months (RR: 0.82, 95% CI: 0.72-0.92, P =0.0008, I2 =82%) but not at >36 months (RR: 0.83, 95% CI: 0.58-1.19, P =0.30, I2 =94%). The adverse events reported with Bevacizumab use included thrombocytopenia, neutropenia, leukocytopenia, anemia, hypertension, bleeding or hemorrhage, and gastrointestinal, cardiac, and dermatological adverse events.
Bevacizumab may improve progression-free survival within and after 36 months, overall survival within 36 months, and reduce disease progression within 36 months.
本系统评价和荟萃分析旨在评估贝伐珠单抗在卵巢癌患者中较短和较长随访期的疗效和安全性。
我们检索了 Medline、Cochrane 中心、Scopus 和 Google Scholar 中所有应用贝伐珠单抗治疗卵巢癌的 3 期随机对照试验（RCT）。使用 Review Manager 5.4 计算风险比（RR）和危险比（HR）及其 95%置信区间（CI）。我们使用 Cochrane 偏倚风险工具（RoB 2）版本 2 评估纳入研究的质量。
经过标题、摘要和全文筛选，我们将 9 项 RCT 纳入本系统评价和荟萃分析。其中 4 项 RCT 偏倚风险较低，5 项 RCT 存在一定的偏倚担忧。贝伐珠单抗与<36 个月（HR：0.59，95%CI：0.45-0.76，P<0.0001，I2=90%）和>36 个月（HR：0.66，95%CI：0.55-0.80，P<0.0001，I2=80%）的无进展生存期改善相关，以及<36 个月（HR：0.87，95%CI：0.78-0.98，P=0.02，I2=0%）的总生存期改善相关，但与>36 个月（HR：0.98，95%CI：0.89-1.09，P=0.77，I2=30%）的总生存期改善无关。在<36 个月（RR：0.95，95%CI：0.86-1.04，P=0.26，I2=10%）或>36 个月（RR：1.02，95%CI：0.97-1.06，P=0.50，I2=0%）的干预组和对照组之间，死亡无差异。贝伐珠单抗降低了<36 个月（RR：0.82，95%CI：0.72-0.92，P=0.0008，I2=82%）和>36 个月（RR：0.83，95%CI：0.58-1.19，P=0.30，I2=94%）的疾病进展率。报道的贝伐珠单抗使用相关的不良反应包括血小板减少症、中性粒细胞减少症、白细胞减少症、贫血、高血压、出血或出血、胃肠道、心脏和皮肤不良反应。
贝伐珠单抗可能改善<36 个月和 36 个月内的无进展生存期、<36 个月的总生存期和减少<36 个月的疾病进展率。
