PMID- 30087578
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220409
IS  - 1179-1322 (Print)
IS  - 1179-1322 (Electronic)
IS  - 1179-1322 (Linking)
VI  - 10
DP  - 2018
TI  - Bevacizumab combined with chemotherapy vs single-agent therapy in recurrent 
      glioblastoma: evidence from randomized controlled trials.
PG  - 2193-2205
LID - 10.2147/CMAR.S173323 [doi]
AB  - BACKGROUND: Recent studies showed inconsistent results of bevacizumab combined 
      with chemotherapy vs single-agent therapy in terms of their safety and efficacy 
      for the treatment of recurrent glioblastoma. Therefore, we performed a 
      meta-analysis to explore the value of bevacizumab combined with chemotherapy and 
      single-agent therapy in recurrent glioblastoma treatment. METHODS: Databases such 
      as MEDLINE, Embase, and Cochrane Library were searched for randomized controlled 
      trials (RCTs) related to the topic of bevacizumab combined with chemotherapy and 
      single-agent therapy as treatments for recurrent glioblastoma from January 1980 
      to April 2018. Subsequent articles were then sorted, evaluated, and analyzed. 
      RESULTS: We pooled 1,169 patient cases from seven RCTs. Bevacizumab combined with 
      chemotherapy showed a significantly improved progression-free survival (PFS) 
      (HR=0.65; 95% CI 0.57-0.74; P<0.001) compared to single-agent therapy. In 
      addition, the overall survival (OS) rate showed insignificant differences between 
      the two groups (HR=0.96; 95% CI 0.83-1.12; P=0.622). Simultaneously, we found 
      that bevacizumab combined with chemotherapy had a higher objective response rate 
      (ORR) (OR=2.10; 95% CI 1.32-3.33; P=0.002), but also higher incidence of adverse 
      events (AEs) (OR=1.85; 95% CI 1.26-2.71; P=0.002). However, in subgroup analysis, 
      we found that AEs showed insignificant differences between the two treatment 
      methods when bevacizumab was used as the single-agent therapy subgroup (P=0.058). 
      In addition, in the subgroup with low corticosteroid use rate at baseline 
      (N<50%), ORR (P=0.108) and AEs (P=0.134) showed insignificant differences between 
      the two groups. CONCLUSION: Bevacizumab combined with chemotherapy can 
      significantly improve PFS and ORR, but did not prolong OS in these studies, and 
      can even lead to higher odds of AEs. In addition, bevacizumab may play a dominant 
      role and corticosteroid may be an unfavorable factor in the combination therapy 
      of recurrent glioblastoma.
FAU - Chen, Zhouqing
AU  - Chen Z
AD  - Department of Neurosurgery, The First Affiliated Hospital of Soochow Unicersity, 
      Suzhou, Jiangsu Province 215006, China, wangzhong761@163.com.
FAU - Xu, Na
AU  - Xu N
AD  - State Key Laboratory of Medical Neurobiology, Institute of Brain Sciences and 
      Collaborative Innovation Center for Brain Science, Fudan University, Shanghai 
      200032, China.
FAU - Zhao, Chongshun
AU  - Zhao C
AD  - Department of Neurosurgery, The First Affiliated Hospital of Soochow Unicersity, 
      Suzhou, Jiangsu Province 215006, China, wangzhong761@163.com.
FAU - Xue, Tao
AU  - Xue T
AD  - Department of Neurosurgery, The First Affiliated Hospital of Soochow Unicersity, 
      Suzhou, Jiangsu Province 215006, China, wangzhong761@163.com.
FAU - Wu, Xin
AU  - Wu X
AD  - Department of Neurosurgery, The First Affiliated Hospital of Soochow Unicersity, 
      Suzhou, Jiangsu Province 215006, China, wangzhong761@163.com.
FAU - Wang, Zhong
AU  - Wang Z
AD  - Department of Neurosurgery, The First Affiliated Hospital of Soochow Unicersity, 
      Suzhou, Jiangsu Province 215006, China, wangzhong761@163.com.
LA  - eng
PT  - Journal Article
DEP - 20180723
PL  - New Zealand
TA  - Cancer Manag Res
JT  - Cancer management and research
JID - 101512700
PMC - PMC6061394
OTO - NOTNLM
OT  - bevacizumab
OT  - combination therapy
OT  - meta-analysis
OT  - recurrent glioblastoma
COIS- Disclosure The authors report no conflicts of interest in this work.
EDAT- 2018/08/09 06:00
MHDA- 2018/08/09 06:01
PMCR- 2018/07/23
CRDT- 2018/08/09 06:00
PHST- 2018/08/09 06:00 [entrez]
PHST- 2018/08/09 06:00 [pubmed]
PHST- 2018/08/09 06:01 [medline]
PHST- 2018/07/23 00:00 [pmc-release]
AID - cmar-10-2193 [pii]
AID - 10.2147/CMAR.S173323 [doi]
PST - epublish
SO  - Cancer Manag Res. 2018 Jul 23;10:2193-2205. doi: 10.2147/CMAR.S173323. 
      eCollection 2018.