Obaid Ur Rehman, Eeshal Fatima, Hiba Imran, Umar Akram, Amna Badar Ahmad, Zain Ali Nadeem, Laveeza Fatima, Ahmad Hussain, Manar Alaa Mabrouk, Muhammad Zain Farooq
{"title":"贝伐单抗联合疗法与标准化疗治疗卵巢癌的随访时间长短对比：随机对照试验的系统回顾和元分析》。","authors":"Obaid Ur Rehman, Eeshal Fatima, Hiba Imran, Umar Akram, Amna Badar Ahmad, Zain Ali Nadeem, Laveeza Fatima, Ahmad Hussain, Manar Alaa Mabrouk, Muhammad Zain Farooq","doi":"10.1097/COC.0000000000001100","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>Bevacizumab may improve progression-free survival within and after 36 months, overall survival within 36 months, and reduce disease progression within 36 months.</p>","PeriodicalId":50812,"journal":{"name":"American Journal of Clinical Oncology-Cancer Clinical Trials","volume":" ","pages":"399-408"},"PeriodicalIF":1.6000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Bevacizumab Combination Therapy Versus Standard Chemotherapy for Ovarian Cancer in Shorter and Longer Follow-Up Duration: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.\",\"authors\":\"Obaid Ur Rehman, Eeshal Fatima, Hiba Imran, Umar Akram, Amna Badar Ahmad, Zain Ali Nadeem, Laveeza Fatima, Ahmad Hussain, Manar Alaa Mabrouk, Muhammad Zain Farooq\",\"doi\":\"10.1097/COC.0000000000001100\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>Bevacizumab may improve progression-free survival within and after 36 months, overall survival within 36 months, and reduce disease progression within 36 months.</p>\",\"PeriodicalId\":50812,\"journal\":{\"name\":\"American Journal of Clinical Oncology-Cancer Clinical Trials\",\"volume\":\" \",\"pages\":\"399-408\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Clinical Oncology-Cancer Clinical Trials\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/COC.0000000000001100\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/6/21 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Clinical Oncology-Cancer Clinical Trials","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/COC.0000000000001100","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/21 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
Bevacizumab Combination Therapy Versus Standard Chemotherapy for Ovarian Cancer in Shorter and Longer Follow-Up Duration: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Objective: 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.
Methods: 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).
Results: 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.
Conclusion: Bevacizumab may improve progression-free survival within and after 36 months, overall survival within 36 months, and reduce disease progression within 36 months.
期刊介绍：
American Journal of Clinical Oncology is a multidisciplinary journal for cancer surgeons, radiation oncologists, medical oncologists, GYN oncologists, and pediatric oncologists.
The emphasis of AJCO is on combined modality multidisciplinary loco-regional management of cancer. The journal also gives emphasis to translational research, outcome studies, and cost utility analyses, and includes opinion pieces and review articles.
The editorial board includes a large number of distinguished surgeons, radiation oncologists, medical oncologists, GYN oncologists, pediatric oncologists, and others who are internationally recognized for expertise in their fields.
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