{"title":"Efficacy and safety of neoadjuvant bevacizumab plus chemotherapy in locally advanced gastric cancer patients: a retrospective, comparative study.","authors":"Bin Yin, Wei Luo","doi":"10.1186/s12957-024-03624-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The clinical benefits of neoadjuvant bevacizumab plus chemotherapy in locally advanced gastric cancer patients are controversial. This study intended to evaluate the efficacy and safety of neoadjuvant bevacizumab plus chemotherapy in these patients.</p><p><strong>Methods: </strong>In this retrospective study, 71 locally advanced gastric cancer patients receiving neoadjuvant bevacizumab plus chemotherapy or neoadjuvant chemotherapy alone were divided into bevacizumab plus chemo group (N = 23) and chemo group (N = 48).</p><p><strong>Results: </strong>Objective response rate (52.2% vs. 35.4%), disease control rate (91.3% vs. 81.3%), surgical resection rate (95.7% vs. 85.4%), R0 resection rate (87.0% vs. 75.0%), and the proportion of patients with tumor regression grade 0-1 (31.8% vs. 17.1%) tended to increase in bevacizumab plus chemo group versus chemo group, although there was no statistical significance. The 48-month progression-free survival (PFS) rates were 58.3% and 33.4% in bevacizumab plus chemo group and chemo group. The 48-month overall survival (OS) rates were 65.1% and 46.5% in bevacizumab plus chemo group and chemo group, respectively. PFS tended to ascend, but OS did not vary in bevacizumab plus chemo group versus chemo group. Bevacizumab plus chemo (vs. chemo) independently related to longer PFS [hazard ratio (HR) = 0.263, P = 0.015], but not OS (HR = 0.207, P = 0.056) in locally advanced gastric cancer patients. The incidence of grade 3-4 adverse events did not vary between groups (all P > 0.05).</p><p><strong>Conclusion: </strong>Neoadjuvant bevacizumab plus chemotherapy achieves higher treatment response and longer survival to some extent, with tolerable adverse events versus neoadjuvant chemotherapy alone in locally advanced gastric cancer patients, but its application needs further verification.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"26"},"PeriodicalIF":2.5000,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773743/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Surgical Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12957-024-03624-x","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: The clinical benefits of neoadjuvant bevacizumab plus chemotherapy in locally advanced gastric cancer patients are controversial. This study intended to evaluate the efficacy and safety of neoadjuvant bevacizumab plus chemotherapy in these patients.
Methods: In this retrospective study, 71 locally advanced gastric cancer patients receiving neoadjuvant bevacizumab plus chemotherapy or neoadjuvant chemotherapy alone were divided into bevacizumab plus chemo group (N = 23) and chemo group (N = 48).
Results: Objective response rate (52.2% vs. 35.4%), disease control rate (91.3% vs. 81.3%), surgical resection rate (95.7% vs. 85.4%), R0 resection rate (87.0% vs. 75.0%), and the proportion of patients with tumor regression grade 0-1 (31.8% vs. 17.1%) tended to increase in bevacizumab plus chemo group versus chemo group, although there was no statistical significance. The 48-month progression-free survival (PFS) rates were 58.3% and 33.4% in bevacizumab plus chemo group and chemo group. The 48-month overall survival (OS) rates were 65.1% and 46.5% in bevacizumab plus chemo group and chemo group, respectively. PFS tended to ascend, but OS did not vary in bevacizumab plus chemo group versus chemo group. Bevacizumab plus chemo (vs. chemo) independently related to longer PFS [hazard ratio (HR) = 0.263, P = 0.015], but not OS (HR = 0.207, P = 0.056) in locally advanced gastric cancer patients. The incidence of grade 3-4 adverse events did not vary between groups (all P > 0.05).
Conclusion: Neoadjuvant bevacizumab plus chemotherapy achieves higher treatment response and longer survival to some extent, with tolerable adverse events versus neoadjuvant chemotherapy alone in locally advanced gastric cancer patients, but its application needs further verification.
目的：新辅助贝伐单抗联合化疗治疗局部进展期胃癌的临床疗效存在争议。本研究旨在评估新辅助贝伐单抗加化疗对这些患者的疗效和安全性。方法：回顾性研究71例局部进展期胃癌患者，分别接受新辅助贝伐单抗联合化疗或单独新辅助化疗，分为贝伐单抗联合化疗组（N = 23）和化疗组（N = 48）。结果：贝伐单抗联合化疗组客观有效率（52.2% vs. 35.4%）、疾病控制率（91.3% vs. 81.3%）、手术切除率（95.7% vs. 85.4%）、R0切除率（87.0% vs. 75.0%）、0-1级肿瘤消退患者比例（31.8% vs. 17.1%）较化疗组有增加的趋势，但差异无统计学意义。贝伐单抗联合化疗组和化疗组的48个月无进展生存（PFS）率分别为58.3%和33.4%。贝伐单抗联合化疗组和化疗组的48个月总生存率分别为65.1%和46.5%。在贝伐单抗联合化疗组和化疗组，PFS有上升趋势，但OS没有变化。贝伐单抗加化疗（vs.化疗）与局部晚期胃癌患者更长的PFS独立相关[风险比(HR) = 0.263, P = 0.015]，但与OS无关（HR = 0.207, P = 0.056）。3-4级不良事件发生率组间差异无统计学意义（P < 0.05）。结论：与单纯新辅助化疗相比，新辅助贝伐单抗联合化疗在局部进展期胃癌患者中具有更高的治疗效果和更长的生存期，不良事件可耐受，但其应用仍需进一步验证。
期刊介绍：
World Journal of Surgical Oncology publishes articles related to surgical oncology and its allied subjects, such as epidemiology, cancer research, biomarkers, prevention, pathology, radiology, cancer treatment, clinical trials, multimodality treatment and molecular biology. Emphasis is placed on original research articles. The journal also publishes significant clinical case reports, as well as balanced and timely reviews on selected topics.
Oncology is a multidisciplinary super-speciality of which surgical oncology forms an integral component, especially with solid tumors. Surgical oncologists around the world are involved in research extending from detecting the mechanisms underlying the causation of cancer, to its treatment and prevention. The role of a surgical oncologist extends across the whole continuum of care. With continued developments in diagnosis and treatment, the role of a surgical oncologist is ever-changing. Hence, World Journal of Surgical Oncology aims to keep readers abreast with latest developments that will ultimately influence the work of surgical oncologists.
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