PMID- 24801910
OWN - NLM
STAT- MEDLINE
DCOM- 20150113
LR  - 20211021
IS  - 1423-0380 (Electronic)
IS  - 1010-4283 (Linking)
VI  - 35
IP  - 8
DP  - 2014 Aug
TI  - The role of anti-VEGF agents in the treatment of advanced gastric cancer: a 
      meta-analysis of randomized controlled trials.
PG  - 7675-83
LID - 10.1007/s13277-014-2037-3 [doi]
AB  - Inhibition of vascular epithelial growth factor (VEGF) signaling pathways has 
      proven to be an effective strategy for the treatment of several common solid 
      tumors, but its role in the management of advanced gastric cancer (AGC) is yet to 
      be defined. We performed a meta-analysis of randomized controlled trials (RCTs) 
      to assess the efficacy and safety of anti-VEGF agents in the treatment of AGC. 
      Several databases were searched, including PubMed, Embase, and Cochrane 
      databases. The endpoints were overall survival (OS), progression-free survival 
      (PFS), overall response rate (ORR), and grade 3 or 4 adverse events (AEs). The 
      pooled hazard ratio (HR) or relative risk (RR) and 95 % confidence intervals (CI) 
      were calculated employing fixed- or random-effects models depending on the 
      heterogeneity of the included trials. Seven RCTs which involved 2,340 patients 
      were ultimately identified. The pooled analysis demonstrated that anti-VEGF 
      therapy significantly improved OS (HR 0.74, 95 % CI 0.61-0.91, p = 0.003), PFS 
      (HR 0.59, 95 % CI 0.44-0.78, p < 0.001), and ORR (RR 1.43, 95 % CI 1.14-1.79, 
      p = 0.002) when compared to non-anti-VEGF therapy. Sensitivity analysis further 
      confirmed this association. Additionally, more incidences of grade 3 or 4 
      thrombocytopenia, diarrhea, and hypertension were observed in anti-VEGF therapy. 
      The anti-VEGF therapy offers a significant survival benefit in patients with AGC, 
      especially for those previously treated patients, when compared to non-anti-VEGF 
      therapy. With the present available data from randomized clinical trials, we 
      could not clearly set the role of specific anti-VEGF agents in the treatment of 
      AGC. Further studies are recommended to identify patients who could derive 
      greater benefits from specific anti-VEGF agents.
FAU - Qi, Wei-Xiang
AU  - Qi WX
AD  - Department of Oncology, Shanghai Jiao Tong University affiliated Sixth People's 
      Hospital, No. 600, Yishan Road, Shanghai, 200233, China, qiweixiang1113@163.com.
FAU - Shen, Zan
AU  - Shen Z
FAU - Tang, Li-Na
AU  - Tang LN
FAU - Yao, Yang
AU  - Yao Y
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20140507
PL  - Netherlands
TA  - Tumour Biol
JT  - Tumour biology : the journal of the International Society for Oncodevelopmental 
      Biology and Medicine
JID - 8409922
RN  - 0 (Vascular Endothelial Growth Factor A)
SB  - IM
MH  - Disease-Free Survival
MH  - Humans
MH  - Publication Bias
MH  - Randomized Controlled Trials as Topic
MH  - Stomach Neoplasms/*drug therapy/mortality
MH  - Vascular Endothelial Growth Factor A/*antagonists & inhibitors
EDAT- 2014/05/08 06:00
MHDA- 2015/01/15 06:00
CRDT- 2014/05/08 06:00
PHST- 2014/03/11 00:00 [received]
PHST- 2014/04/28 00:00 [accepted]
PHST- 2014/05/08 06:00 [entrez]
PHST- 2014/05/08 06:00 [pubmed]
PHST- 2015/01/15 06:00 [medline]
AID - 10.1007/s13277-014-2037-3 [doi]
PST - ppublish
SO  - Tumour Biol. 2014 Aug;35(8):7675-83. doi: 10.1007/s13277-014-2037-3. Epub 2014 
      May 7.