Zeyi Zhao, Lei Cheng, Xin Tong, Shuai Xu, Qingqing Zhuang
{"title":"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。","authors":"Zeyi Zhao, Lei Cheng, Xin Tong, Shuai Xu, Qingqing Zhuang","doi":"10.1080/14796694.2025.2548188","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To appraise the efficacy and toxicity of adding bevacizumab to neoadjuvant chemotherapy (NACT) for advanced-stage ovarian cancer (AOC).</p><p><strong>Method: </strong>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.</p><p><strong>Results: </strong>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; I<sup>2</sup> = 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; I<sup>2</sup> = 0%), with an incidence of 1.2% (95% CI: 0% to 3.6%; I<sup>2</sup> = 34%).</p><p><strong>Conclusion: </strong>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.</p><p><strong>Protocol registration: </strong>www.crd.york.ac.uk/prospero identifier is CRD42024566484.</p>","PeriodicalId":12672,"journal":{"name":"Future oncology","volume":" ","pages":"2921-2929"},"PeriodicalIF":2.6000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439575/pdf/","citationCount":"0","resultStr":"{\"title\":\"The benefits and pitfalls of adding bevacizumab to neoadjuvant chemotherapy for advanced ovarian cancer: a meta-analysis.\",\"authors\":\"Zeyi Zhao, Lei Cheng, Xin Tong, Shuai Xu, Qingqing Zhuang\",\"doi\":\"10.1080/14796694.2025.2548188\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To appraise the efficacy and toxicity of adding bevacizumab to neoadjuvant chemotherapy (NACT) for advanced-stage ovarian cancer (AOC).</p><p><strong>Method: </strong>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.</p><p><strong>Results: </strong>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; I<sup>2</sup> = 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; I<sup>2</sup> = 0%), with an incidence of 1.2% (95% CI: 0% to 3.6%; I<sup>2</sup> = 34%).</p><p><strong>Conclusion: </strong>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.</p><p><strong>Protocol registration: </strong>www.crd.york.ac.uk/prospero identifier is CRD42024566484.</p>\",\"PeriodicalId\":12672,\"journal\":{\"name\":\"Future oncology\",\"volume\":\" \",\"pages\":\"2921-2929\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439575/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Future oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/14796694.2025.2548188\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/8/22 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Future oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/14796694.2025.2548188","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/22 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
The benefits and pitfalls of adding bevacizumab to neoadjuvant chemotherapy for advanced ovarian cancer: a meta-analysis.
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.
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.
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