Efficacy and safety of bevacizumab in the treatment of adult gliomas: a systematic review and meta-analysis
Objective To assess the efficacy and safety of bevacizumab (BEV) in patients with glioma.Design Systematic review and meta-analysis.Participants Adults aged 18 years and above, whose histology was confirmed to be malignant glioma.Primary and secondary outcome measures The main indicators included pr...
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BMJ Publishing Group
2021-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/11/12/e048975.full |
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| author | Kai Wang Jianxin Guo Tianze Sun Tianze Wang Zhuojun Wu |
| author_facet | Kai Wang Jianxin Guo Tianze Sun Tianze Wang Zhuojun Wu |
| author_sort | Kai Wang |
| collection | DOAJ |
| description | Objective To assess the efficacy and safety of bevacizumab (BEV) in patients with glioma.Design Systematic review and meta-analysis.Participants Adults aged 18 years and above, whose histology was confirmed to be malignant glioma.Primary and secondary outcome measures The main indicators included progression-free survival (PFS) rate and overall survival (OS) rate, and the secondary indicators were adverse reactions.Results A total of 11 clinical centre trials were included in this study for meta-analysis, including 2392 patients. The results of the meta-analysis showed that the median PFS rate of the BEV group was significantly higher than that of the non-BEV group (p<0.00001). When comparing PFS between two groups, we found that the PFS in the BEV group was higher than that in the non-BEV group at 6 months (OR 3.31, 95% CI 2.74 to 4.00, p<0.00001), 12 months (OR 2.05, 95% CI 1.70 to 2.49, p<0.00001) and 18 months (OR 1.31, 95% CI 1.02 to 1.69, p=0.03). But at 24 months (OR 0.83, 95% CI 0.50 to 1.37, p=0.47), there was no significant difference between the two groups. At 30 months (OR 0.62, 95% CI 0.39 to 0.97, p=0.04), the PFS of the BEV group was lower than that of the non-BEV group. Moreover, The results showed that BEV had no significant effect on improving OS, but the adverse reaction in BEV group was significantly higher than that in non-BEV group.Conclusion The evidence suggests that BEV can significantly prolong the PFS of patients with glioma within 18 months and shorten the PFS of patients after 30 months. This limitation may be related to the subgroup of patients, the change of recurrence mode, the optimal dose of drug, the increase of hypoxia, the enhancement of invasiveness and so on. Therefore, it is necessary to carry out more samples and higher quality large-scale research in the future. |
| format | Article |
| id | doaj-art-2bb32194898c48319f6db75c9386ffbb |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2021-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-2bb32194898c48319f6db75c9386ffbb2025-08-20T02:21:46ZengBMJ Publishing GroupBMJ Open2044-60552021-12-01111210.1136/bmjopen-2021-048975Efficacy and safety of bevacizumab in the treatment of adult gliomas: a systematic review and meta-analysisKai Wang0Jianxin Guo1Tianze Sun2Tianze Wang3Zhuojun Wu4Department of Neurosurgery, Shaanxi University of Chinese Medicine, Xianyang, ChinaDepartment of Medical Imaging, the first affiliated Hospital of Medical College of Xi`an Jiaotong University, Xi`an Jiaotong University, Xi`an, China1 National Centre for Youth Substance Use Research, The University of Queensland, Saint Lucia, Queensland, AustraliaMajor in Neurosurgery, Xi`an Jiaotong University, Xi`an, ChinaDepartment of Medical Imaging, the first affiliated Hospital of Medical College of Xi`an Jiaotong University, Xi`an Jiaotong University, Xi`an, ChinaObjective To assess the efficacy and safety of bevacizumab (BEV) in patients with glioma.Design Systematic review and meta-analysis.Participants Adults aged 18 years and above, whose histology was confirmed to be malignant glioma.Primary and secondary outcome measures The main indicators included progression-free survival (PFS) rate and overall survival (OS) rate, and the secondary indicators were adverse reactions.Results A total of 11 clinical centre trials were included in this study for meta-analysis, including 2392 patients. The results of the meta-analysis showed that the median PFS rate of the BEV group was significantly higher than that of the non-BEV group (p<0.00001). When comparing PFS between two groups, we found that the PFS in the BEV group was higher than that in the non-BEV group at 6 months (OR 3.31, 95% CI 2.74 to 4.00, p<0.00001), 12 months (OR 2.05, 95% CI 1.70 to 2.49, p<0.00001) and 18 months (OR 1.31, 95% CI 1.02 to 1.69, p=0.03). But at 24 months (OR 0.83, 95% CI 0.50 to 1.37, p=0.47), there was no significant difference between the two groups. At 30 months (OR 0.62, 95% CI 0.39 to 0.97, p=0.04), the PFS of the BEV group was lower than that of the non-BEV group. Moreover, The results showed that BEV had no significant effect on improving OS, but the adverse reaction in BEV group was significantly higher than that in non-BEV group.Conclusion The evidence suggests that BEV can significantly prolong the PFS of patients with glioma within 18 months and shorten the PFS of patients after 30 months. This limitation may be related to the subgroup of patients, the change of recurrence mode, the optimal dose of drug, the increase of hypoxia, the enhancement of invasiveness and so on. Therefore, it is necessary to carry out more samples and higher quality large-scale research in the future.https://bmjopen.bmj.com/content/11/12/e048975.full |
| spellingShingle | Kai Wang Jianxin Guo Tianze Sun Tianze Wang Zhuojun Wu Efficacy and safety of bevacizumab in the treatment of adult gliomas: a systematic review and meta-analysis BMJ Open |
| title | Efficacy and safety of bevacizumab in the treatment of adult gliomas: a systematic review and meta-analysis |
| title_full | Efficacy and safety of bevacizumab in the treatment of adult gliomas: a systematic review and meta-analysis |
| title_fullStr | Efficacy and safety of bevacizumab in the treatment of adult gliomas: a systematic review and meta-analysis |
| title_full_unstemmed | Efficacy and safety of bevacizumab in the treatment of adult gliomas: a systematic review and meta-analysis |
| title_short | Efficacy and safety of bevacizumab in the treatment of adult gliomas: a systematic review and meta-analysis |
| title_sort | efficacy and safety of bevacizumab in the treatment of adult gliomas a systematic review and meta analysis |
| url | https://bmjopen.bmj.com/content/11/12/e048975.full |
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