The benefits and pitfalls of adding bevacizumab to neoadjuvant chemotherapy for advanced ovarian cancer: a meta-analysis.

IF 2.6 4区医学 Q2 ONCOLOGY

Future oncology Pub Date : 2025-09-01 Epub Date: 2025-08-22 DOI:10.1080/14796694.2025.2548188

Zeyi Zhao, Lei Cheng, Xin Tong, Shuai Xu, Qingqing Zhuang

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引用次数: 0

Abstract

Objective: To appraise the efficacy and toxicity of adding bevacizumab to neoadjuvant chemotherapy (NACT) for advanced-stage ovarian cancer (AOC).

Method: All studies regarding neoadjuvant bevacizumab for AOC published in PubMed, EMBASE, Scopus and Web of Science from 1 November 2010 to 31 December 2024 were retrieved and reviewed.

Results: Three randomized clinical trials, five retrospective cohort studies, and six case series were eligible, including 687 patients receiving bevacizumab-NACT and 1482 patients receiving standard-NACT. There were no significant differences between the bevacizumab-NACT group and the standard-NACT group in the rates of interval debulking surgery implementation, achieving complete cytoreduction, wound complication, thrombogenesis, and infections (grade ≥3). The rate of achieving optimal cytoreduction in bevacizumab-NACT group was significantly higher than that in standard-NACT group (RR: 1.17, 95% CI: 1.02 to 1.34, P = 0.02; I² = 30%). However, the bevacizumab-NACT group exhibited an increased risk of gastrointestinal perforation (RR: 6.97, 95% CI: 1.28 to 37.99, P = 0.02; I² = 0%), with an incidence of 1.2% (95% CI: 0% to 3.6%; I² = 34%).

Conclusion: Adding bevacizumab to NACT for AOC can enhance the feasibility of optimal cytoreduction, rather than complete cytoreduction. However, bevacizumab-NACT increased the risk of gastrointestinal perforation.

Protocol registration: www.crd.york.ac.uk/prospero identifier is CRD42024566484.

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晚期卵巢癌新辅助化疗中加入贝伐单抗的益处和缺陷：一项荟萃分析。

目的：评价贝伐单抗联合新辅助化疗（NACT）治疗晚期卵巢癌（AOC）的疗效和毒性。方法：检索2010年11月1日至2024年12月31日在PubMed、EMBASE、Scopus和Web of Science上发表的所有关于新辅助贝伐单抗治疗AOC的研究。结果：纳入3项随机临床试验、5项回顾性队列研究和6个病例系列，其中接受贝伐单抗- nact治疗的患者687例，接受标准nact治疗的患者1482例。贝伐单抗- nact组与标准nact组在间隔减容手术实施率、完全细胞减少率、伤口并发症、血栓形成率和感染率（分级≥3级）方面无显著差异。贝伐单抗- nact组达到最佳细胞减数率显著高于标准nact组（RR: 1.17, 95% CI: 1.02 ~ 1.34, P = 0.02; I2 = 30%）。然而，贝伐单抗- nact组胃肠道穿孔的风险增加（RR: 6.97, 95% CI: 1.28 ~ 37.99, P = 0.02; I2 = 0%），发生率为1.2% （95% CI: 0% ~ 3.6%; I2 = 34%）。结论：贝伐单抗联合NACT治疗AOC可增强最佳细胞减少的可行性，但不能完全减少细胞。然而，贝伐单抗- nact增加了胃肠道穿孔的风险。协议注册：www.crd.york.ac.uk/prospero标识为CRD42024566484。

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

Future oncology ONCOLOGY-

CiteScore

5.40

自引率

3.00%

发文量

335

审稿时长

4-8 weeks

期刊介绍： Future Oncology (ISSN 1479-6694) provides a forum for a new era of cancer care. The journal focuses on the most important advances and highlights their relevance in the clinical setting. Furthermore, Future Oncology delivers essential information in concise, at-a-glance article formats - vital in delivering information to an increasingly time-constrained community. The journal takes a forward-looking stance toward the scientific and clinical issues, together with the economic and policy issues that confront us in this new era of cancer care. The journal includes literature awareness such as the latest developments in radiotherapy and immunotherapy, concise commentary and analysis, and full review articles all of which provide key findings, translational to the clinical setting.