PMID- 37289304 OWN - NLM STAT- MEDLINE DCOM- 20230612 LR - 20231221 IS - 1432-1262 (Electronic) IS - 0179-1958 (Linking) VI - 38 IP - 1 DP - 2023 Jun 8 TI - Different doses of bevacizumab in combination with chemotherapy for advanced colorectal cancer: a meta-analysis and Bayesian analysis. PG - 164 LID - 10.1007/s00384-023-04442-5 [doi] AB - OBJECTIVE: The aim of the present study was to explore the incremental benefit of bevacizumab (Bev) in the treatment of advanced colorectal cancer (CRC) with different doses. METHODS: A literature search of eight electronic databases (China National Knowledge Infrastructure, Wanfang databases, Chinese Biomedical Database, VIP medicine information, Cochrane Library, MEDLINE, PubMed, and EMBASE) was conducted from database creation to December 2022. Randomized controlled trials (RCTs) that compared Bev at various dosages + chemotherapy (CT) versus placebo (or blank control) + CT were selected. The overall survival (OS), progression-free survival (PFS), overall response rate (ORR; complete response [CR] + partial response [PR]), and grade >/= 3 adverse events (AEs) were integrated first by pooled analysis. The likelihood of ideal dosage of Bev was then ranked using random effects within Bayesian analysis. RESULTS: Twenty-six RCTs involving 18,261 patients met the inclusion criteria. OS increased significantly after using 5 mg (HR: 0.87, 95% CI 0.75 to 1.00) and 10 mg dosages of Bev (HR: 0.75, 95% CI 0.66 to 0.85) with CT, but statistical significance was not attained for the 7.5 mg dose (HR: 0.95, 95% CI 0.83 to 1.08). A significantly increased in PFS with doses of 5 mg (HR: 0.69, 95% CI 0.58 to 0.83), 7.5 mg (HR: 0.81, 95% CI 0.66 to 1.00), and 10 mg (HR: 0.60, 95% CI 0.53 to 0.68). ORR distinctly increased after 5 mg (RR: 1.34, 95% CI 1.15 to 1.55), 7.5 mg (RR: 1.25, 95% CI 1.05 to 1.50), and10 mg (RR: 2.27, 95% CI 1.82 to 2.84) doses were administered. Grade >/= 3 AEs increased clearly in 5 mg (RR: 1.11, 95% CI 1.04 to 1.20) compared to 7.5 mg (RR: 1.05, 95% CI 0.82 to 1.35) and 10 mg (RR: 1.15, 95% CI 0.98 to 1.36). Bayesian analysis demonstrated that 10 mg Bev obtained the maximum time of OS (HR: 0.75, 95% CrI 0.58 to 0.97; probability rank = 0.05) indirectly compared to 5 mg and 7.5 mg Bev. Compared with 5 mg and 7.5 mg Bev, 10 mg Bev also holds the longest duration for PFS (HR: 0.59, 95% CrI 0.43 to 0.82; probability rank = 0.00). In terms of ORR, 10 mg Bev holds the maximum frequency (RR: 2.02, 95% CrI 1.52 to 2.66; probability rank = 0.98) in comparison to 5 mg and 7.5 mg Bev clearly. For grade >/= 3 AEs, 10 mg Bev has the maximum incidence (RR: 1.15, 95% CrI 0.95 to 1.40, probability rank = 0.67) in comparison to other doses of Bev. CONCLUSION: The study suggests that 10 mg dose Bev could be more effective in treating advanced CRC in efficacy, but 5 mg Bev could be more safer in terms of safety. CI - (c) 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. FAU - Deng, Jia AU - Deng J AD - College of Clinical Medicine, Guizhou University of Traditional Chinese Medicine, Guiyang, China. FAU - Zeng, Xinglin AU - Zeng X AD - College of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China. FAU - Hu, Wenting AU - Hu W AD - College of Clinical Medicine, Guizhou University of Traditional Chinese Medicine, Guiyang, China. FAU - Yue, Tinghui AU - Yue T AD - College of Clinical Medicine, Guizhou University of Traditional Chinese Medicine, Guiyang, China. FAU - Luo, Zicheng AU - Luo Z AD - College of Clinical Medicine, Guizhou University of Traditional Chinese Medicine, Guiyang, China. FAU - Zeng, Lian AU - Zeng L AD - College of Clinical Medicine, Guizhou University of Traditional Chinese Medicine, Guiyang, China. FAU - Li, Ping AU - Li P AD - Colorectal and Anal Surgery, the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, No 71 Baoshan North Road, Guiyang, 550001, China. 418835868@qq.com. FAU - Chen, Jiang AU - Chen J AD - Colorectal and Anal Surgery, the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, No 71 Baoshan North Road, Guiyang, 550001, China. chenjiang05v92@163.com. LA - eng GR - No. 2018XMSB00012180/Guizhou Provincial Health and Family Planning Commission/ GR - No. 2018XMSB00012180/Guizhou Provincial Health and Family Planning Commission/ GR - No. GYZYYFY-BS-2022(01)/Doctoral Initiation Fund of the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine/ GR - No. GYZYYFY-BS-2022(01)/Doctoral Initiation Fund of the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine/ GR - No. QianKeHe Foundation -ZK[2023] General 437/the Science and Technology Project of Guizhou Province/ GR - No. QianKeHe Foundation -ZK[2023] General 437/the Science and Technology Project of Guizhou Province/ PT - Journal Article PT - Meta-Analysis PT - Review DEP - 20230608 PL - Germany TA - Int J Colorectal Dis JT - International journal of colorectal disease JID - 8607899 RN - 2S9ZZM9Q9V (Bevacizumab) SB - IM MH - Humans MH - Bevacizumab/adverse effects MH - Bayes Theorem MH - *Colorectal Neoplasms MH - Progression-Free Survival MH - China MH - Antineoplastic Combined Chemotherapy Protocols/adverse effects OTO - NOTNLM OT - Advanced colorectal cancer OT - Bayesian analysis OT - Bevacizumab OT - Chemotherapy OT - Meta-analysis EDAT- 2023/06/08 13:07 MHDA- 2023/06/12 06:42 CRDT- 2023/06/08 11:08 PHST- 2023/05/21 00:00 [accepted] PHST- 2023/06/12 06:42 [medline] PHST- 2023/06/08 13:07 [pubmed] PHST- 2023/06/08 11:08 [entrez] AID - 10.1007/s00384-023-04442-5 [pii] AID - 10.1007/s00384-023-04442-5 [doi] PST - epublish SO - Int J Colorectal Dis. 2023 Jun 8;38(1):164. doi: 10.1007/s00384-023-04442-5.