PMID- 30233875
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220321
IS  - 2072-1439 (Print)
IS  - 2077-6624 (Electronic)
IS  - 2072-1439 (Linking)
VI  - 10
IP  - 8
DP  - 2018 Aug
TI  - Incidence and risk of thromboembolism associated with bevacizumab in patients 
      with non-small cell lung carcinoma.
PG  - 5010-5022
LID - 10.21037/jtd.2018.07.09 [doi]
AB  - BACKGROUND: Bevacizumab, a recombinant humanized monoclonal antibody against 
      vascular endothelial growth factor (VEGF), is effective for the treatment of 
      advanced non-small cell lung cancer (NSCLC). However, severe adverse events (AEs) 
      have been reported in NSCLC patients treated with bevacizumab. Currently, the 
      contribution of Bevacizumab to thromboembolism is still controversial. We 
      conducted a study to determine the overall risk and incidence of thromboembolism 
      with bevacizumab in NSCLC patients. METHODS: Electronic databases such as the 
      PubMed, Web of Science and Cochrane Library were searched for related trials. 
      Statistical analyses were conducted to calculate the overall incidence rates, 
      odds ratios (ORs), and 95% confidence intervals (CIs) by using either 
      random-effect or fixed-effect models depending on the heterogeneity. We also used 
      trial sequence analysis (TSA) to verify the pooled result. RESULTS: A total of 
      3,555 subjects from nine studies were included. The overall incidence of 
      thromboembolism events in NSCLC patients treated with bevacizumab was 4.8% (95% 
      CI: 1.9-7.7%). Without bevacizumab, this incidence was 2.9% (95% CI: 0.6-5.1%). 
      Bevacizumab use was associated with a significantly increased risk in 
      thromboembolism events (OR =1.74; 95% CI: 1.15-2.62; P=0.008). Subgroup analysis 
      based on the doses showed that bevacizumab administered at 15 mg/kg (OR =1.81; 
      95% CI: 1.14-2.86; P=0.012), but not 7.5 mg/kg (OR =1.32; 95% CI: 0.78-2.24; 
      P=0.296), increased the risk of thromboembolism. CONCLUSIONS: Bevacizumab is 
      associated with a significantly increased risk of thromboembolism development in 
      NSCLC patients. It may have dose-toxicity relationship and low dose of 
      bevacizumab may be a better choice for NSCLC patients, with equal efficacy and 
      low hazard of thromboembolism events.
FAU - Li, Li-Juan
AU  - Li LJ
AD  - Nanshan School, Guangzhou Medical University, Guangzhou 511436, China.
FAU - Chen, Di-Fei
AU  - Chen DF
AD  - Nanshan School, Guangzhou Medical University, Guangzhou 511436, China.
FAU - Wu, Guo-Feng
AU  - Wu GF
AD  - The 3rd Affiliated Hospital of Guangzhou Medical University Li-Wan Hospital, 
      Guangzhou 510170, China.
FAU - Guan, Wei-Jie
AU  - Guan WJ
AD  - State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of 
      Guangzhou Medical University, National Clinical Research Center for Respiratory, 
      Guangzhou Institute of Respiratory Health, Guangzhou 510120, China.
FAU - Zhu, Zheng
AU  - Zhu Z
AD  - State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of 
      Guangzhou Medical University, National Clinical Research Center for Respiratory, 
      Guangzhou Institute of Respiratory Health, Guangzhou 510120, China.
FAU - Liu, Yi-Qian
AU  - Liu YQ
AD  - State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of 
      Guangzhou Medical University, National Clinical Research Center for Respiratory, 
      Guangzhou Institute of Respiratory Health, Guangzhou 510120, China.
FAU - Gao, Guo-Ying
AU  - Gao GY
AD  - State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of 
      Guangzhou Medical University, National Clinical Research Center for Respiratory, 
      Guangzhou Institute of Respiratory Health, Guangzhou 510120, China.
FAU - Qin, Yin-Yin
AU  - Qin YY
AD  - State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of 
      Guangzhou Medical University, National Clinical Research Center for Respiratory, 
      Guangzhou Institute of Respiratory Health, Guangzhou 510120, China.
FAU - Zhong, Nan-Shan
AU  - Zhong NS
AD  - State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of 
      Guangzhou Medical University, National Clinical Research Center for Respiratory, 
      Guangzhou Institute of Respiratory Health, Guangzhou 510120, China.
LA  - eng
PT  - Journal Article
PL  - China
TA  - J Thorac Dis
JT  - Journal of thoracic disease
JID - 101533916
PMC - PMC6129907
OTO - NOTNLM
OT  - Bevacizumab
OT  - lung cancer
OT  - meta-analysis
OT  - thromboembolism
COIS- Conflicts of Interest: The authors have no conflicts of interest to declare.
EDAT- 2018/09/21 06:00
MHDA- 2018/09/21 06:01
PMCR- 2018/08/01
CRDT- 2018/09/21 06:00
PHST- 2018/09/21 06:00 [entrez]
PHST- 2018/09/21 06:00 [pubmed]
PHST- 2018/09/21 06:01 [medline]
PHST- 2018/08/01 00:00 [pmc-release]
AID - jtd-10-08-5010 [pii]
AID - 10.21037/jtd.2018.07.09 [doi]
PST - ppublish
SO  - J Thorac Dis. 2018 Aug;10(8):5010-5022. doi: 10.21037/jtd.2018.07.09.