Efficacy and safety of bevacizumab combined with temozolomide in the treatment of glioma a systematic review and meta-analysis of clinical trials.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-10-24 DOI:10.1016/j.wneu.2024.10.071
Chuheng Wang, Linan Duan, Yao Zhao, Yubo Wang, Yunqian Li
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Abstract

Objective: Glioma is the most common malignant brain tumor in neurosurgery. Bevacizumab (BEV) is a monoclonal antibody that inhibits tumors by inhibiting vascular endothelial growth factor and reducing tumor angiogenesis. To evaluate the efficacy and safety of BEV combined with temozolomide (TMZ) in glioma, we performed a meta-analysis.

Methods: PubMed, Embase, The Cochrane Library, and Web of Science databases were searched for randomized controlled trials comparing survival outcomes between TMZ combined with BEV and TMZ alone as well as cohort studies were included in our study. The primary outcome measures analyzed were overall survival (OS) and progression-free survival (PFS).

Results: A total of six randomized controlled trials and four cohort studies with a total of 2515 patients were included in our meta-analysis. The results of meta-analysis suggested that there were no significant improvements in overall survival, but the combination of TMZ and BEV prolonged progression-free survival, improved overall response rate (ORR), and increased the incidence of some adverse reactions, compared with TMZ alone. Subgroup analysis suggested sex, recursive partitioning analysis (RPA) grade, MGMT gene status and radiotherapy combination did not affect the improvement of OS with the combination of the two drugs, and RPA grade did not affect the improvement of PFS with the combination of the two drugs.

Conclusions: The combination of TMZ and BEV can improve PFS as well as ORR in patients and has no benefit on OS. At the same time, the adverse reactions during the combination of the two drugs were acceptable.

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贝伐单抗联合替莫唑胺治疗胶质瘤的疗效和安全性:临床试验的系统回顾和荟萃分析。
目的:胶质瘤是神经外科最常见的恶性脑肿瘤。贝伐单抗(BEV)是一种单克隆抗体,通过抑制血管内皮生长因子和减少肿瘤血管生成来抑制肿瘤。为了评估贝伐单抗联合替莫唑胺(TMZ)治疗胶质瘤的疗效和安全性,我们进行了一项荟萃分析:我们在 PubMed、Embase、The Cochrane Library 和 Web of Science 数据库中搜索了比较 TMZ 联合 BEV 和单独使用 TMZ 的生存结果的随机对照试验,并将队列研究纳入研究。分析的主要结果指标为总生存期(OS)和无进展生存期(PFS):我们的荟萃分析共纳入了六项随机对照试验和四项队列研究,共计 2515 例患者。荟萃分析结果表明,与单用TMZ相比,联合应用TMZ和BEV可延长无进展生存期,提高总反应率(ORR),并增加一些不良反应的发生率。亚组分析表明,性别、递归分区分析(RPA)分级、MGMT基因状态和放疗组合不影响两药联合治疗对OS的改善,RPA分级不影响两药联合治疗对PFS的改善:结论:TMZ和BEV联合用药可改善患者的PFS和ORR,对OS无益。结论:TMZ和BEV联合用药可改善患者的PFS和ORR,但对OS无益,同时,两种药物联合用药期间的不良反应是可以接受的。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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