PMID- 34617297
OWN - NLM
STAT- MEDLINE
DCOM- 20220304
LR  - 20220304
IS  - 1365-2710 (Electronic)
IS  - 0269-4727 (Linking)
VI  - 47
IP  - 2
DP  - 2022 Feb
TI  - The efficacy and toxicity of maintenance therapy with bevacizumab plus pemetrexed 
      versus bevacizumab/pemetrexed alone for stage IIIB/IV nonsquamous non-small cell 
      lung cancer: A meta-analysis of randomized controlled trials.
PG  - 157-167
LID - 10.1111/jcpt.13534 [doi]
AB  - WHAT IS KNOWN AND OBJECTIVE: Whether maintenance therapy with bevacizumab (Bev) + 
      pemetrexed (Pem) can achieve greater clinical benefits than Bev or Pem alone for 
      stage IIIB/IV nonsquamous non-small cell lung cancer (NSCLC) remains unclear. We 
      assessed the antitumour effect and toxicity of maintenance Bev+Pem versus 
      maintenance with single-agent Bev/Pem in this meta-analysis. METHODS: Appropriate 
      randomized controlled trials (RCTs) were screened using electronic databases 
      (Google Scholar, PubMed, Embase, Scopus, ScienceDirect, Ovid MEDLINE, Cochrane 
      and Web of Science). The endpoints were progression-free survival (PFS), overall 
      survival (OS) and adverse events (AEs). RESULTS AND DISCUSSION: We included six 
      RCTs that contained 2,447 patients receiving induction therapy with 
      platinum-based combination therapies. The maintenance therapy Bev+Pem group had 
      prolonged PFS (HR = 0.74, 95% CI 0.69-0.80, p < 0.00001) and OS (HR = 0.91, 95% 
      CI 0.83-0.99, p = 0.02) compared with the Bev/Pem group. Moreover, we further 
      analysed the PFS rate (PFSR) and OS rate (OSR) and found that the Bev+Pem group 
      exhibited improved PFSR-0.5y, PFSR-1y, PFSR-1.5y, PFSR-2y and OS-2y, with 
      preferable trends in OS-1y, OS-3y and OS-4y compared with the Bev/Pem 
      single-agent maintenance therapy. In addition, subgroup analyses indicated that 
      the Bev+Pem group had greater PFS and OS among patients aged <65 years, patients 
      with an Eastern Cooperative Oncology Group (ECOG) score of 0, and patients who 
      never smoked. Regarding adverse events (AEs), the Bev+Pem group exhibited an 
      increased occurrence of anaemia, fatigue, thrombocytopenia and anorexia. WHAT IS 
      NEW AND CONCLUSION: For stage IIIB/IV nonsquamous NSCLC patients, maintenance 
      therapy with Bev+Pem offers an increased survival outcome (PFS, OS) compared with 
      monotherapy. However, the increased incidence of AEs should not be neglected.
CI  - (c) 2021 John Wiley & Sons Ltd.
FAU - Liu, Miaowen
AU  - Liu M
AD  - Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang 
      University, Nanchang, China.
AD  - Jiangxi Medical College, Nanchang University, Nanchang, China.
FAU - Luo, Nachuan
AU  - Luo N
AD  - Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang 
      University, Nanchang, China.
AD  - Jiangxi Medical College, Nanchang University, Nanchang, China.
FAU - Fang, Zige
AU  - Fang Z
AD  - Jiangxi Medical College, Nanchang University, Nanchang, China.
AD  - Department of Oncology, The Second Affiliated Hospital of Nanchang University, 
      Nanchang, China.
FAU - Liu, Qiangyun
AU  - Liu Q
AD  - Jiangxi Medical College, Nanchang University, Nanchang, China.
AD  - Department of Oncology, The Second Affiliated Hospital of Nanchang University, 
      Nanchang, China.
FAU - Yi, Fengming
AU  - Yi F
AD  - Department of Oncology, The Second Affiliated Hospital of Nanchang University, 
      Nanchang, China.
FAU - Wei, Yiping
AU  - Wei Y
AD  - Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang 
      University, Nanchang, China.
FAU - Zhang, Xinyi
AU  - Zhang X
AD  - Department of Respiratory Diseases, The Second Affiliated Hospital of Nanchang 
      University, Nanchang, 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, Nanchang, China.
LA  - eng
GR  - 20203BBGL73148/Project of the Science and Technology Department of Jiangxi 
      province/
GR  - 20171BAB215040/The Youth Science Foundation from the Science and Technology 
      Department of Jiangxi province/
GR  - 170107/Project of Jiangxi Provincial Department of Education/
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
DEP - 20211006
PL  - England
TA  - J Clin Pharm Ther
JT  - Journal of clinical pharmacy and therapeutics
JID - 8704308
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Drug Combinations)
RN  - 04Q9AIZ7NO (Pemetrexed)
RN  - 2S9ZZM9Q9V (Bevacizumab)
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Antineoplastic Agents/administration & dosage/adverse effects/*therapeutic use
MH  - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
MH  - Bevacizumab/administration & dosage/adverse effects/*therapeutic use
MH  - Carcinoma, Non-Small-Cell Lung/*drug therapy/mortality/pathology
MH  - Drug Combinations
MH  - Female
MH  - Humans
MH  - Lung Neoplasms/*drug therapy/mortality/pathology
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Staging
MH  - Pemetrexed/administration & dosage/adverse effects/*therapeutic use
MH  - Progression-Free Survival
MH  - Randomized Controlled Trials as Topic
MH  - Sex Factors
OTO - NOTNLM
OT  - bevacizumab
OT  - maintenance therapy
OT  - meta-analysis
OT  - nonsquamous non-small cell lung cancer
OT  - pemetrexed
EDAT- 2021/10/08 06:00
MHDA- 2022/03/05 06:00
CRDT- 2021/10/07 07:11
PHST- 2021/09/16 00:00 [revised]
PHST- 2021/08/22 00:00 [received]
PHST- 2021/09/22 00:00 [accepted]
PHST- 2021/10/08 06:00 [pubmed]
PHST- 2022/03/05 06:00 [medline]
PHST- 2021/10/07 07:11 [entrez]
AID - 10.1111/jcpt.13534 [doi]
PST - ppublish
SO  - J Clin Pharm Ther. 2022 Feb;47(2):157-167. doi: 10.1111/jcpt.13534. Epub 2021 Oct 
      6.