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贝伐单抗在胶质母细胞瘤患者中的不良反应及应用:一项系统评价和荟萃分析。

The Adverse Effects and Use of Bevacizumab in Patients with Glioblastoma: A Systematic Review and Meta-Analysis.

作者信息

Bruna-Mejías Alejandro, Silva-Bravo Vicente, Moyano Valarezo Laura, Delgado-Retamal María Fernanda, Nazar-Izquierdo Diego, Aguilar-Aguirre Isidora, Nova-Baeza Pablo, Orellana-Donoso Mathias, Suazo-Santibáñez Alejandra, Gutiérrez-Espinoza Héctor, Sanchis Gimeno Juan, Bastidas-Caldes Carlos, Valenzuela Fuenzalida Juan José

机构信息

Departamento de Ciencias y Geografía, Facultad de Ciencias Naturales y Exactas, Universidad de Playa Ancha, Valparaíso 2360072, Chile.

Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370146, Chile.

出版信息

Pharmaceuticals (Basel). 2025 May 25;18(6):795. doi: 10.3390/ph18060795.

Abstract

: A glioblastoma (GBM) is a type of tumor originating from the glial brain cells, the astrocytes, and thus belongs to the astrocytoma group. Bevacizumab (BV) is a treatment for GBM. BV is the active ingredient in the drugs Avastin, Alymsys, Mvasi and ZiraBev. It is currently approved as second-line treatment for GBM recurrence in combination with radiotherapy, and as first-line treatment for other cancers, including advanced colorectal cancer, metastatic breast cancer and advanced non-small-cell lung cancer. The objective of this systematic review was to analyze the scientific evidence from the science-based literature on the therapeutic effect and adverse effects of the drug BV in patients with GBM or GBM multiforme. : We systematically searched electronic databases for the literature search, including the MEDLINE (via PubMed), SCOPUS, Google Scholar, the Cumulative Index to Nursing and Allied Health Literature and Web of Science databases, covering records from their earliest data to December 2024. Randomized or controlled clinical trials that were published in English or Spanish were included. The following keywords were used in different combinations: "Bevacizumab therapy", "Bevacizumab pharmaceutical", "Glioblastoma", "Glioma" and "multiform glioblastoma". : The use of Bevacizumab has been extensively studied in the scientific literature, with beneficial effects in symptom control. However, the adverse effects of BV vary across different types of carcinomas, which is why it has already been established that these adverse effects must be taken into consideration. In our meta-analysis of adverse effects, we found 14 adverse effects and estimated their prevalence, with an average of 19% (CI: 4 to 44%). The most significant vascular adverse effect was thromboembolism, which led to a greater number of complications for patients with GBM. Finally, the most common adverse effects were nausea, vomiting, fatigue and hypertension. : While the beneficial properties of this pharmacological therapy have been observed, its adverse effect profile requires constant evaluation, as it includes vascular, blood and symptomatic adverse effects, which must be analyzed on a case-by-case basis and with great attention, especially in the case of more serious complications such as thromboembolic events.

摘要

胶质母细胞瘤(GBM)是一种起源于神经胶质脑细胞(星形胶质细胞)的肿瘤,因此属于星形细胞瘤组。贝伐单抗(BV)是一种治疗GBM的药物。BV是阿瓦斯汀、阿利姆西、穆瓦西和齐拉贝伐等药物的活性成分。它目前被批准作为GBM复发的二线治疗药物,与放疗联合使用,同时作为包括晚期结直肠癌、转移性乳腺癌和晚期非小细胞肺癌在内的其他癌症的一线治疗药物。本系统评价的目的是分析基于科学的文献中关于药物BV对GBM或多形性GBM患者治疗效果和不良反应的科学证据。

我们系统地检索了电子数据库以进行文献检索,包括MEDLINE(通过PubMed)、SCOPUS、谷歌学术、护理及相关健康文献累积索引和科学引文索引数据库,涵盖从最早数据到2024年12月的记录。纳入以英文或西班牙文发表的随机或对照临床试验。使用了以下不同组合的关键词:“贝伐单抗治疗”、“贝伐单抗药物”、“胶质母细胞瘤”、“神经胶质瘤”和“多形性胶质母细胞瘤”。

贝伐单抗的使用在科学文献中已得到广泛研究,对症状控制有有益效果。然而,BV的不良反应在不同类型的癌症中有所不同,这就是为什么已经确定必须考虑这些不良反应。在我们对不良反应的荟萃分析中,我们发现了14种不良反应并估计了它们的发生率,平均为19%(置信区间:4%至44%)。最显著的血管不良反应是血栓栓塞,这给GBM患者带来了更多并发症。最后,最常见的不良反应是恶心、呕吐、疲劳和高血压。

虽然已经观察到这种药物治疗的有益特性,但其不良反应情况需要持续评估,因为它包括血管、血液和症状性不良反应,必须逐案进行分析并予以高度关注,尤其是在出现血栓栓塞事件等更严重并发症的情况下。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dfc/12196191/3c380ddb81d6/pharmaceuticals-18-00795-g001.jpg

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