PMID- 30922256
OWN - NLM
STAT- MEDLINE
DCOM- 20190715
LR  - 20231006
IS  - 1471-2407 (Electronic)
IS  - 1471-2407 (Linking)
VI  - 19
IP  - 1
DP  - 2019 Mar 28
TI  - Efficacy of bevacizumab combined with erlotinib for advanced hepatocellular 
      carcinoma: a single-arm meta-analysis based on prospective studies.
PG  - 276
LID - 10.1186/s12885-019-5487-6 [doi]
LID - 276
AB  - BACKGROUND: The efficacy of bevacizumab combined with erlotinib (B + E) for the 
      treatment of advanced hepatocellular carcinoma, especially for 
      sorafenib-refractory patients, has been observed and evaluated in several trials. 
      We conducted this single arm meta-analysis to generally assess the benefit and 
      risk with B + E for advanced hepatocellular carcinoma. METHODS: The PubMed, 
      Cochrane Library, Embase, ScienceDirect, Web of Science and Scopus databases were 
      searched for related studies. The main outcomes were objective response rate 
      (ORR), disease control rate (DCR), overall survival (OS), progression-free 
      survival (PFS) and adverse effects (AEs). RESULTS: Eight phase II clinical trials 
      including 342 hepatocellular carcinoma patients were analyzed. The pooled ORR was 
      12.6% (95% CI: 6.3-19.0%), and the pooled DCR was 54.5% (95% CI: 48.9-66.8%). The 
      16-week PFS rate was 50.2% (95% CI: 38.2-62.2%). The 6- and 12-month OS rates 
      were 77.8% (95% CI: 71.3-84.2%) and 44.9% (95% CI: 36.8-53.0%). The main grade 
      3-4 AEs were fatigue (11.9%), diarrhea (9.0%), hypertension (6.7%), acne (5.8%) 
      and hemorrhage (5.3%). The only RCT showed that the B + E regimen had a 
      consistent response and equable median OS but fewer toxicities (grade 3-4 AEs: 
      19% vs. 27%) than sorafenib. Subgroup analysis showed that as a second-line 
      treatment, the B + E regimen had substantial value with a favorable PFS-16w 
      (P = 0.012), OS-12 m (P = 0.048) and a favorable tendency of ORR (P = 0.089), but 
      obvious toxicities in the second-line setting could not be neglected. CONCLUSION: 
      Bevacizumab combined with erlotinib is effective for treating hepatocellular 
      carcinoma patients, especially sorafenib-refractory patients. More well-designed 
      and large-scale RCTs are warranted to prove our findings.
FAU - He, Liyun
AU  - He L
AD  - Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang 
      University, 1 Minde Rd, Nanchang, 330006, Jiangxi Province, China.
AD  - Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.
FAU - Deng, Huan
AU  - Deng H
AD  - Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang 
      University, 1 Minde Rd, Nanchang, 330006, Jiangxi Province, China.
AD  - Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.
FAU - Lei, Jun
AU  - Lei J
AD  - Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Nanchang 
      University, Nanchang, 330006, China.
FAU - Yi, Fengming
AU  - Yi F
AD  - Department of Oncology, The Second Affiliated Hospital of Nanchang University, 
      Nanchang, 330006, China.
FAU - Li, Jine
AU  - Li J
AD  - Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.
FAU - Fan, Xiu De
AU  - Fan X
AD  - Department of Infectious Diseases, The First Affiliated Hospital of Xi'an 
      Jiaotong University, Xi'an, 710061, China.
FAU - Wei, Yiping
AU  - Wei Y
AD  - Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang 
      University, 1 Minde Rd, Nanchang, 330006, Jiangxi Province, China.
FAU - Xu, Jianjun
AU  - Xu J
AD  - Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang 
      University, 1 Minde Rd, Nanchang, 330006, Jiangxi Province, China.
FAU - Zhang, Wenxiong
AU  - Zhang W
AUID- ORCID: 0000-0003-2962-0847
AD  - Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang 
      University, 1 Minde Rd, Nanchang, 330006, Jiangxi Province, China. 
      zwx123dr@126.com.
LA  - eng
GR  - 81560345/National Natural Science Foundation of Chin/
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20190328
PL  - England
TA  - BMC Cancer
JT  - BMC cancer
JID - 100967800
RN  - 2S9ZZM9Q9V (Bevacizumab)
RN  - DA87705X9K (Erlotinib Hydrochloride)
SB  - IM
MH  - Antineoplastic Combined Chemotherapy Protocols/administration & dosage/adverse 
      effects
MH  - Bevacizumab/*administration & dosage/adverse effects
MH  - Carcinoma, Hepatocellular/*drug therapy
MH  - Clinical Trials, Phase II as Topic
MH  - Erlotinib Hydrochloride/*administration & dosage/adverse effects
MH  - Female
MH  - Humans
MH  - Liver Neoplasms/*drug therapy
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Survival Analysis
MH  - Treatment Outcome
PMC - PMC6437948
OTO - NOTNLM
OT  - Bevacizumab
OT  - Erlotinib
OT  - Hepatocellular carcinoma
OT  - Meta-analysis
OT  - Sorafenib
COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: Not applicable. CONSENT FOR 
      PUBLICATION: Not applicable. COMPETING INTERESTS: The authors declare that they 
      have no competing interests. PUBLISHER'S NOTE: Springer Nature remains neutral 
      with regard to jurisdictional claims in published maps and institutional 
      affiliations.
EDAT- 2019/03/30 06:00
MHDA- 2019/07/16 06:00
PMCR- 2019/03/28
CRDT- 2019/03/30 06:00
PHST- 2018/09/11 00:00 [received]
PHST- 2019/03/19 00:00 [accepted]
PHST- 2019/03/30 06:00 [entrez]
PHST- 2019/03/30 06:00 [pubmed]
PHST- 2019/07/16 06:00 [medline]
PHST- 2019/03/28 00:00 [pmc-release]
AID - 10.1186/s12885-019-5487-6 [pii]
AID - 5487 [pii]
AID - 10.1186/s12885-019-5487-6 [doi]
PST - epublish
SO  - BMC Cancer. 2019 Mar 28;19(1):276. doi: 10.1186/s12885-019-5487-6.