Efficacy and Safety of Bevacizumab Combined with Temozolomide in the Treatment of Glioma: A Systematic Review and Meta-Analysis of Clinical Trials

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery Pub Date : 2025-01-01 DOI:10.1016/j.wneu.2024.10.071

Chuheng Wang, Linan Duan, Yao Zhao, Yubo Wang, Yunqian Li

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引用次数: 0

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 6 randomized controlled trials and 4 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, and increased the incidence of some adverse reactions, compared with TMZ alone. Subgroup analysis suggested sex, recursive partitioning analysis grade, O-6-methylguanine-DNA methyltransferase gene status and radiotherapy combination did not affect the improvement of OS with the combination of the 2 drugs, and recursive partitioning analysis grade did not affect the improvement of PFS with the combination of the 2 drugs.

Conclusions

The combination of TMZ and BEV can improve PFS as well as overall response rate in patients and has no benefit on OS. At the same time, the adverse reactions during the combination of the 2 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。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World neurosurgery CLINICAL NEUROLOGY-SURGERY

CiteScore

3.90

自引率

15.00%

发文量

1765

审稿时长

47 days

期刊介绍： World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS