Dataset Information

Optimizing Outcomes: Bevacizumab with Carboplatin and Paclitaxel in 5110 Ovarian Cancer Patients-A Systematic Review and Meta-Analysis.

ABSTRACT:

Background/objectives

The study aimed to evaluate the efficacy and safety of incorporating bevacizumab into the combination therapy of carboplatin and paclitaxel for epithelial ovarian cancer and other clinical applications.

Methods

A systematic review was conducted following PRISMA guidelines using keyword searches in PubMed, Embase, Cochrane Library, CINAHL, ClinicalTrials.gov, and ICTRP until February 2024. Randomized controlled trials (RCTs) comparing carboplatin and paclitaxel with and without bevacizumab in ovarian cancer patients were included. Efficacy outcomes were overall survival (OS) and progression-free survival (PFS), as described by hazard ratios (HRs). Safety outcomes were analyzed with risk ratios (RRs) for 16 adverse events.

Results

Seven RCTs (n = 5110) were included. The combination with bevacizumab significantly improved PFS (HR: 0.73; 95% confidence interval: 0.58, 0.92; p = 0.008). The chemotherapy group receiving bevacizumab with carboplatin and paclitaxel showed a significantly higher incidence of hypertension, non-CNS bleeding, thromboembolic events, GI perforation, pain, and proteinuria.

Conclusions

The combination of carboplatin, paclitaxel, and bevacizumab improves PFS compared to the regimen without bevacizumab, but it raises significant safety concerns. Clinical management should consider adverse event prevention by vigilantly monitoring blood pressure, signs and symptoms of bleeding, thromboembolism, GI perforation, and pain to balance the therapeutic benefits with the potential risks of this combination therapy.

SUBMITTER: Kim YJ

PROVIDER: S-EPMC11359859 | biostudies-literature | 2024 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Optimizing Outcomes: Bevacizumab with Carboplatin and Paclitaxel in 5110 Ovarian Cancer Patients-A Systematic Review and Meta-Analysis.

Kim Yu Jin YJ Lee Hee Min HM Lee Ga Eun GE Yoo Jin Hui JH Lee Hwa Jeong HJ Rhie Sandy Jeong SJ

Pharmaceuticals (Basel, Switzerland) 20240821 8

<h4>Background/objectives</h4>The study aimed to evaluate the efficacy and safety of incorporating bevacizumab into the combination therapy of carboplatin and paclitaxel for epithelial ovarian cancer and other clinical applications.<h4>Methods</h4>A systematic review was conducted following PRISMA guidelines using keyword searches in PubMed, Embase, Cochrane Library, CINAHL, ClinicalTrials.gov, and ICTRP until February 2024. Randomized controlled trials (RCTs) comparing carboplatin and paclitaxe ...[more]

PMID: 39204200

Similar Datasets

Project description:ContextA previous randomized trial demonstrated that adding bevacizumab to carboplatin and paclitaxel improved survival in advanced non-small cell lung cancer (NSCLC). However, longer survival was not observed in the subgroup of patients aged 65 years or older.ObjectiveTo examine whether adding bevacizumab to carboplatin and paclitaxel chemotherapy is associated with improved survival in older patients with NSCLC.Design, setting, and participantsRetrospective cohort study of 4168 Medicare beneficiaries aged 65 years or older with stage IIIB or stage IV non-squamous cell NSCLC diagnosed in 2002-2007 in a Surveillance, Epidemiology, and End Results (SEER) region. Patients were categorized into 3 cohorts based on diagnosis year and type of initial chemotherapy administered within 4 months of diagnosis: (1) diagnosis in 2006-2007 and bevacizumab-carboplatin-paclitaxel therapy; (2) diagnosis in 2006-2007 and carboplatin-paclitaxel therapy; or (3) diagnosis in 2002-2005 and carboplatin-paclitaxel therapy. The associations between carboplatin-paclitaxel with vs without bevacizumab and overall survival were compared using Cox proportional hazards models and propensity score analyses including information about patient characteristics recorded in SEER-Medicare.Main outcome measureOverall survival measured from the first date of chemotherapy treatment until death or the censoring date of December 31, 2009.ResultsThe median survival estimates were 9.7 (interquartile range [IQR], 4.4-18.6) months for bevacizumab-carboplatin-paclitaxel, 8.9 (IQR, 3.5-19.3) months for carboplatin-paclitaxel in 2006-2007, and 8.0 (IQR, 3.7-17.2) months for carboplatin-paclitaxel in 2002-2005. One-year survival probabilities were 39.6% (95% CI, 34.6%-45.4%) for bevacizumab-carboplatin-paclitaxel vs 40.1% (95% CI, 37.4%-43.0%) for carboplatin-paclitaxel in 2006-2007 and 35.6% (95% CI, 33.8%-37.5%) for carboplatin-paclitaxel in 2002-2005. Neither multivariable nor propensity score-adjusted Cox models demonstrated a survival advantage for bevacizumab-carboplatin-paclitaxel compared with carboplatin-paclitaxel cohorts. In propensity score-stratified models, the hazard ratio for overall survival for bevacizumab-carboplatin-paclitaxel compared with carboplatin-paclitaxel in 2006-2007 was 1.01 (95% CI, 0.89-1.16; P = .85) and compared with carboplatin-paclitaxel in 2002-2005 was 0.93 (95% CI, 0.83-1.06; P = .28). The propensity score-weighted model and propensity score-matching model similarly failed to demonstrate a statistically significant superiority for bevacizumab-carboplatin-paclitaxel. Subgroup and sensitivity analyses for key variables did not change these findings.ConclusionAdding bevacizumab to carboplatin and paclitaxel chemotherapy was not associated with better survival among Medicare patients with advanced NSCLC.

Dataset Information

Optimizing Outcomes: Bevacizumab with Carboplatin and Paclitaxel in 5110 Ovarian Cancer Patients-A Systematic Review and Meta-Analysis.

Background/objectives

Methods

Results

Conclusions

Publications

Optimizing Outcomes: Bevacizumab with Carboplatin and Paclitaxel in 5110 Ovarian Cancer Patients-A Systematic Review and Meta-Analysis.

Similar Datasets

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