Clinical Research Papers:
Efficacy and toxicity of bevacizumab in recurrent ovarian disease: an update meta-analysis on phase III trials
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Abstract
Claudia Marchetti1,*, Francesca De Felice2,*, Innocenza Palaia1, Angela Musella1, Violante Di Donato1, Maria Luisa Gasparri1, Daniela Musio2, Ludovico Muzii1, Vincenzo Tombolini2, Pierluigi Benedetti Panici1
1Department of Obstetrics-Gynecological Sciences and Urological Sciences, Policlinico Umberto I “Sapienza” University of Rome, Viale del Policlinico, Rome 00161, Italy
2Department of Radiotherapy, Policlinico Umberto I “Sapienza” University of Rome, Viale Regina Elena, Rome 00161, Italy
*These authors contributed equally to this work
Correspondence to:
Francesca De Felice, e-mail: [email protected]
Keywords: bevacizumab, ovarian cancer, recurrent, survival, toxicity
Received: September 02, 2015 Accepted: November 10, 2015 Published: December 08, 2015
ABSTRACT
Background: To analyze the efficacy and toxicity of bevacizumab on survival outcomes in recurrent ovarian cancer.
Results: Bevacizumab was associated with significant improvement of PFS and OS compared with standard treatment with HRs of 0.53 (95% CI 0.44 − 0.63; p < 0.00001) and 0.87 (95% CI, 0.77 to 0.99; p = 0.03), respectively.
Bevacizumab increased the incidence of G3/G4 hypertension (RR 19.01, 95% CI 7.77 – 46.55; p < 0.00001), proteinuria (RR 17.31, 95% CI 5.42 − 55.25; p < 0.00001), arterial thromboembolic events (ATE) (RR 4.99, 95% CI 1.29 − 19.27; p = 0.02) and bleeding (RR 3.14, 95% CI 1.35 – 7.32; p = 0.008).
Materials and Methods: Three randomized phase III trials representing 1502 patients were identified.
Pooled hazard ratio (HR), odd ratio (OR), risk ratio (RR) with 95% confidence interval (CI) were calculated using fixed or random effects model.
Conclusions: Adding bevacizumab to standard chemotherapy improved ORR, PFS and OS, and it had a higher, but manageable, incidence of toxicities graded 3 to 4.
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