Archives of Gynecology and Obstetrics

, Volume 288, Issue 3, pp 655–666 | Cite as

Bevacizumab in the treatment of ovarian cancer: a meta-analysis from four phase III randomized controlled trials

Gynecologic Oncology

Abstract

Background

The aim of this meta-analysis was to summarize the efficacy and safety of bevacizumab in the treatment of ovarian cancer.

Methods

We sought to identify randomised controlled trials (RCTs) by searching PubMed and Web of Science. Outcomes were objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and adverse events.

Results

Four studies with 4,246 patients were included. Combination of bevacizumab and chemotherapy resulted in a statistically significant improvement in ORR (OR 2.165, 95 % CI 1.511–3.103) and in PFS (HR 0.691, 95 % CI 0.517–0.865), compared with chemotherapy alone. There was no evidence of a significant improvement in OS (HR 0.934, 95 % CI 0.826–1.041). It also had significantly increased risk of gastrointestinal events (OR 2.743, 95 % CI 1.580–4.763; P < 0.001), hypertension (OR 4.630, 95 % CI 3.737 to 5.737; P < 0.001), proteinuria (OR 4.872, 95 % CI 2.617–9.069; P < 0.001), and arterial thromboembolism (OR 1.994, 95 % CI 1.210–3.286; P = 0.007).

Conclusion

This meta-analysis suggests that the addition of bevacizumab to chemotherapy offers meaningful improvement in objective response rate and progression-free survival in ovarian cancer treatment, but does not benefit overall survival. It also significantly increased the occurrence of gastrointestinal events, hypertension, proteinuria, and arterial thromboembolism.

Keywords

Ovarian cancer Vascular endothelial growth factor Monoclonal antibodies Bevacizumab Meta-analysis 

Notes

Acknowledgments

We thank anonymous reviewers and the editor for several insightful comments that significantly improved the paper. We are also grateful to anonymous reviewer for correcting syntax error in the paper.

Conflicts of interest

The authors have declared no conflicts of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyAffiliated Hospital of Nantong UniversityNantongPeople’s Republic of China
  2. 2.Nantong UniversityNantongPeople’s Republic of China

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