The efficacy and safety of paclitaxel and carboplatin with versus without bevacizumab in patients with non-small-cell lung cancer: a systematic review and meta-analysis
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Shiqian Han1,2, Yuanduo Hong2, Tingting Liu1, Na Wu3 and Zhijia Ye1
1Institute of Tropical Medicine, Third Military Medical University, Chongqing 400038, China
2Battalion 17 of Students, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, China
3Department of Epidemiology, Third Military Medical University, Chongqing 400038, China
Zhijia Ye, email: [email protected]
Keywords: bevacizumab; paclitaxel; carboplatin; non-small cell lung cancer; safety
Received: August 16, 2017 Accepted: October 28, 2017 Epub: December 23, 2017 Published: March 06, 2018
Objectives: To investigate the efficacy and safety of Bevacizumab (Bev) used in combination with paclitaxel and carboplatin (PC), compared with PC alone in patients with advanced non-small-cell lung cancer (NSCLC).
Materials and Methods: We searched the PubMed, EMBASE, Cochrane Central Register of Controlled Trials and Chinese Biomedical Literature electronic databases, to identify randomized controlled trials of PC plus Bev versus PC alone for the treatment of NSCLC. The meta-analysis was performed using Reviewer Manager Version 5.3 software provided by the Cochrane Collaboration. The primary endpoint was progression-free survival (PFS), and the secondary endpoints were overall survival (OS), objective response rate (ORR), the incidence of severe adverse events and treatment-related deaths.
Results: The final analysis included 5 trials with a total of 1486 patients. Compared with PC alone, the regimen of PC plus Bev resulted in significantly longer PFS (HR = 0.57; 95% CI = 0.46 to 0.71; p < 0.00001), longer OS (HR = 0.81; 95% CI = 0.71 to 0.92; p = 0.0009) and higher response rates (RR = 2.06; 95% CI = 1.73 to 2.44; p < 0.00001). However, grade ≥ 3 neutropenia, haemoptysis, hypertension, proteinuria and bleeding events were more common among patients who received Bev, and these patients also experienced increased rates of treatment-related death.
Conclusions: Compared with PC alone, the combination of PC with Bev could prolong PFS, OS and RR for patients with advanced non-squamous NSCLC. However, this combination could lead to a higher toxicity profile. Therefore, the benefits and risks should be considered before making treatment decisions.
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