Josée-Lyne Ethier , Cal Shephard , Diana P. Granados , Nikkita Dutta , Rana Qadeer , Saima Ahmad , Ellen Kasireddy , Mir-Masoud Pourrahmat , Mir Sohail Fazeli
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引用次数: 0
Abstract
Objective
First-line therapy for ovarian cancer involves cytoreductive surgery and platinum-based chemotherapy, with or without bevacizumab. Bevacizumab can be administered at low (7.5 mg/kg every three weeks [Q3W]) or high dose (15 mg/kg Q3W). This study compared the efficacy and safety of these dosing strategies.
Methods
Systematic literature review of Embase, MEDLINE®, and CENTRAL (18/09/2023) identified randomized controlled trials (RCTs) evaluating bevacizumab versus any therapy or control in ovarian, fallopian tube, or primary peritoneal cancer. Indirect treatment comparisons (ITC) of response, survival, and safety outcomes were performed, including sensitivity/subgroup analyses adjusting for heterogeneity.
Results
Six RCTs (sample size: 24–1528 patients) were included for ITC. Five evaluated high-dose bevacizumab with chemotherapy. The common comparator was carboplatin + paclitaxel. Trials mainly included stage III (n = 4) or stage II-III (n = 1) ovarian cancer patients; one did not report cancer stage. Primary analyses showed no significant differences between low- versus high-dose bevacizumab for partial response (risk ratio [95 % confidence interval]: 0.66 [0.42, 1.02]), complete response (1.76 [0.76, 4.11]), objective response rate (1.01 [0.63, 1.61]), progressive disease (1.08 [0.38, 3.10]), clinical benefit (0.89 [0.76, 1.03]), any grade ≥ 3 adverse event (1.53 [0.96, 2.44]), specific grade ≥ 3 adverse events, overall survival (hazard ratio: 0.93 [0.77, 1.13]), or progression-free survival (1.02 [0.86, 1.22]). Sensitivity and subgroup analyses confirmed findings.
Conclusions
This ITC found no significant difference in clinical outcomes between low- and high-dose bevacizumab combination therapy. Despite limitations of small sample size and heterogeneities, findings suggest that bevacizumab dose may not significantly impact ovarian cancer outcomes.
期刊介绍:
Gynecologic Oncology, an international journal, is devoted to the publication of clinical and investigative articles that concern tumors of the female reproductive tract. Investigations relating to the etiology, diagnosis, and treatment of female cancers, as well as research from any of the disciplines related to this field of interest, are published.
Research Areas Include:
• Cell and molecular biology
• Chemotherapy
• Cytology
• Endocrinology
• Epidemiology
• Genetics
• Gynecologic surgery
• Immunology
• Pathology
• Radiotherapy