Abstract
ObjectivesTo 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 MethodsWe 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.ResultsThe 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.ConclusionsCompared 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.
Highlights
Non-small-cell lung cancer (NSCLC) is the most common type of lung cancer and the leading cause of cancer-related death in the world [1]
Compared with paclitaxel and carboplatin (PC) alone, the regimen of PC plus Bev resulted in significantly longer progression-free survival (PFS) (HR = 0.57; 95% confidence interval (CI) = 0.46 to 0.71; p < 0.00001), longer overall survival (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)
Compared with PC alone, the combination of PC with Bev could prolong PFS, OS and risk ratio (RR) for patients with advanced non-squamous non-small-cell lung cancer (NSCLC). This combination could lead to a higher toxicity profile
Summary
Non-small-cell lung cancer (NSCLC) is the most common type of lung cancer and the leading cause of cancer-related death in the world [1]. Patients with advanced or metastatic NSCLC have a poor prognosis. Chemotherapy with doublet platinum-based compounds is recommended as the first-line treatment for advanced NSCLC patients, but the treatment benefit is limited [2, 3]. The Eastern Cooperative Oncology Group (ECOG) conducted a randomized study to compare the efficacy and safety of four common platinum-based treatments (cisplatin and gemcitabine, cisplatin and docetaxel, paclitaxel and carboplatin [PC] or paclitaxel and cisplatin). No significant difference in overall survival (OS) was found. These regimens demonstrate modest progress in terms of outcome, with a median survival time of approximately 8 months [4], more effective and/or better tolerated agents for advanced NSCLC are needed
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
