@article{18ff640e0e634be394fc8491e3fef6e4,
title = "Systematic review and meta-analysis of randomised, phase II/III trials adding bevacizumab to platinum-based chemotherapy as first-line treatment in patients with advanced non-small-cell lung cancer",
abstract = "Background: Previous studies have demonstrated the efficacy and safety of bevacizumab in the treatment of non-small-cell lung cancer (NSCLC).Methods: Summary data from randomised trials comparing first-line bevacizumab plus platinum-based chemotherapy with chemotherapy alone for inoperable locally advanced, recurrent or metastatic NSCLC were meta-analysed. Pooled hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS), and pooled odds ratio (OR) for adverse events were calculated. The chi-squared tests evaluated interactions between treatment effects, and prognostic factors and patient characteristics. Results: Data of 2194 patients (1313 bevacizumab; 881 controls) from four phase II and III trials: AVF-0757g, JO19907, ECOG 4599 and AVAiL, were analysed. Compared with chemotherapy alone, bevacizumab significantly prolonged OS (HR 0.90; 95% confidence interval [CI] 0.81, 0.99; P = 0.03), and PFS (0.72; 95% CI 0.66, 0.79; P≤0.001). Bevacizumab showed a significantly greater effect on OS in patients with adenocarcinoma versus other histologies (P = 0.02), and patients with body weight loss ≤5% versus >5% (P = 0.03). Bevacizumab significantly increased the risk of grade ≥3 proteinuria, hypertension, haemorrhagic events, neutropenia, and febrile neutropenia. Conclusions: Bevacizumab significantly prolonged OS and PFS when added to first-line platinum-based chemotherapy in patients with advanced NSCLC; no unexpected toxicity was evident.",
keywords = "Bevacizumab, Carcinoma, Efficacy, Meta-analysis, Non-small-cell lung, Safety",
author = "Soria, {J. C.} and A. Mauguen and M. Reck and Sandler, {A. B.} and N. Saijo and Johnson, {D. H.} and D. Burcoveanu and M. Fukuoka and B. Besse and Pignon, {J. P.}",
note = "Funding Information: This analysis and publication were supported by an unrestricted grant from F. Hoffmann-La Roche Ltd (Basel, Switzerland) and Ligue National Contre le Cancer. We are grateful to Chugai Pharmaceutical Co., Ltd for providing supplementary data on the JO19907 trial. The authors acknowledge the medical writing assistance of Lee Baker of Prism Ideas, Cheshire, UK, supported by F. Hoffman-La Roche. JPP acted as a co-secretariat of the group, co-prepared the protocol, discussed discrepancies in the extraction of the data, led the analysis, reviewed the statistical report, led the drafting of the manuscript and approved the final version. JCS acted as a co-secretariat of the group, reviewed the protocol, reviewed the manuscript at each stage and approved the final version. AM co-prepared the protocol, extracted the data from the literature/reports, carried out the analyses and prepared the statistical report, drafted the manuscript and approved the final version. BB reviewed the protocol, reviewed the manuscript at each stage and approved the final version. DB helped in the preparation of the protocol, extracted the data from the literature/reports, reviewed the manuscript and approved the final version. MR, ABS, NS, DHJ and MF acted as a representative of an analysed trial, provided additional data, reviewed the manuscript and approved the final version. Funding Information: This work was supported by an unrestricted grant from Hoffmann-La Roche Ltd (Basel, Switzerland) and Ligue National Contre le Cancer (there were no grant numbers). The sponsors did not contribute to the analysis, interpretation and reporting of the data. On behalf of his co-authors, JPP had full access to all the study data, and had final responsibility for the decision to submit for publication.",
year = "2013",
month = jan,
day = "1",
doi = "10.1093/annonc/mds590",
language = "English",
volume = "24",
pages = "20--30",
journal = "Annals of Oncology",
issn = "0923-7534",
number = "1",
}