PMID- 38304850
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240203
IS  - 1758-8340 (Print)
IS  - 1758-8359 (Electronic)
IS  - 1758-8340 (Linking)
VI  - 16
DP  - 2024
TI  - Comparison of osimertinib plus bevacizumab against osimertinib alone in NSCLC 
      harboring EGFR mutations: a systematic review and meta-analysis.
PG  - 17588359241227677
LID - 10.1177/17588359241227677 [doi]
LID - 17588359241227677
AB  - BACKGROUND: Frequent failures observed in some trials comparing the efficacy and 
      safety of osimertinib plus bevacizumab to osimertinib monotherapy in advanced 
      non-small-cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) 
      alterations have brought questions. OBJECTIVES: To evaluate the efficacy and 
      safety of these two treatment regimens in advanced NSCLC patients harboring EGFR 
      mutations. DESIGN: This study is a systematic review and meta-analysis. DATA 
      SOURCES AND METHODS: PubMed, Embase, Cochrane Library, Web of Science, CNKI, 
      Wanfang, and VIP databases were extensively searched for relevant randomized 
      controlled trials (RCTs) on 14 May 2023. Two researchers independently screened 
      the literature, assessed quality, and extracted data. The primary outcomes were 
      progression-free survival (PFS), overall survival (OS), and objective response 
      rate (ORR). The secondary outcomes were adverse events (AEs) and PFS stratified 
      by patients' characteristics. STATA 17.0 software (StataCorp LLC, USA) was 
      adopted for meta-analysis. RESULTS: A total of four RCTs involving 390 patients 
      were included. Overall, the risk of bias across the studies was moderate to low. 
      Pooled results showed that compared to osimertinib alone, the addition of 
      bevacizumab to osimertinib failed to show prolongation of PFS [hazard ratio (HR) 
      = 1.00, 95% confidence interval (CI): 0.78-1.27], OS (HR = 1.01, 95% CI: 
      0.73-1.41), or improvement of the ORR (risk ratio = 1.12, 95% CI: 0.90-1.38), 
      while an increased incidence of some AEs was observed, such as nausea, oral 
      mucositis, hypertension, and proteinuria. Notably, combination treatment did 
      significantly prolong the PFS in the subset of smokers (HR = 0.64, 95% CI: 
      0.44-0.94). A mild trend toward PFS benefit under the combined regimen was also 
      noted in patients with brain metastases and first-line treatment, though not 
      reaching statistical significance. CONCLUSION: Based on the available evidence, 
      the addition of bevacizumab to osimertinib could not provide additional survival 
      benefits with higher but manageable toxicity for EGFR-mutant NSCLC patients. 
      Osimertinib monotherapy remains the prioritized treatment. Further investigation 
      is warranted.
CI  - (c) The Author(s), 2024.
FAU - Zhou, Guojin
AU  - Zhou G
AUID- ORCID: 0000-0002-0802-1661
AD  - Department of Pharmacy, The First Affiliated Hospital of Sun Yat-sen University, 
      Guangzhou, China.
AD  - School of Pharmaceutical Science, Sun Yat-sen University, Guangzhou, China.
FAU - Guo, Liuxian
AU  - Guo L
AD  - Department of Pharmacy, The First Affiliated Hospital of Sun Yat-sen University, 
      Guangzhou, China.
AD  - School of Pharmaceutical Science, Sun Yat-sen University, Guangzhou, China.
FAU - Xu, Jing
AU  - Xu J
AD  - Department of Pharmacy, Dermatology Hospital of Southern Medical University, 
      Guangzhou, China.
FAU - Tang, Kejing
AU  - Tang K
AD  - Department of Pharmacy, The First Affiliated Hospital of Sun Yat-sen University, 
      Guangzhou, China.
FAU - Chen, Jie
AU  - Chen J
AUID- ORCID: 0000-0001-5094-3195
AD  - Department of Pharmacy, The First Affiliated Hospital of Sun Yat-sen University, 
      No. 58, Zhong Shan Er Lu, Guangzhou 510080, China.
LA  - eng
PT  - Journal Article
DEP - 20240131
PL  - England
TA  - Ther Adv Med Oncol
JT  - Therapeutic advances in medical oncology
JID - 101510808
PMC - PMC10832416
OTO - NOTNLM
OT  - EGFR
OT  - TKI
OT  - bevacizumab
OT  - non-small-cell lung cancer
OT  - osimertinib
COIS- The authors declare that there is no conflict of interest.
EDAT- 2024/02/02 06:43
MHDA- 2024/02/02 06:44
PMCR- 2024/01/31
CRDT- 2024/02/02 04:14
PHST- 2023/07/19 00:00 [received]
PHST- 2023/12/13 00:00 [accepted]
PHST- 2024/02/02 06:44 [medline]
PHST- 2024/02/02 06:43 [pubmed]
PHST- 2024/02/02 04:14 [entrez]
PHST- 2024/01/31 00:00 [pmc-release]
AID - 10.1177_17588359241227677 [pii]
AID - 10.1177/17588359241227677 [doi]
PST - epublish
SO  - Ther Adv Med Oncol. 2024 Jan 31;16:17588359241227677. doi: 
      10.1177/17588359241227677. eCollection 2024.