Addition Of Bevacizumab To Chemotherapy In Advanced Non-small Cell Lung Cancer: A Systematic Review And Meta-analysis.

dc.creatorLima, André Bacellar Costa
dc.creatorMacedo, Ligia T
dc.creatorSasse, André Deeke
dc.date2011
dc.date2015-11-27T13:21:44Z
dc.date2015-11-27T13:21:44Z
dc.date.accessioned2018-03-29T01:13:41Z
dc.date.available2018-03-29T01:13:41Z
dc.identifierPlos One. v. 6, n. 8, p. e22681, 2011.
dc.identifier1932-6203
dc.identifier10.1371/journal.pone.0022681
dc.identifierhttp://www.ncbi.nlm.nih.gov/pubmed/21829644
dc.identifierhttp://repositorio.unicamp.br/jspui/handle/REPOSIP/199573
dc.identifier21829644
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/1299806
dc.descriptionRecently, studies have demonstrated that the addition of bevacizumab to chemotherapy could be associated with better outcomes in patients with advanced non-small cell lung cancer (NSCLC). However, the benefit seems to be dependent on the drugs used in the chemotherapy regimens. This systematic review evaluated the strength of data on efficacy of the addition of bevacizumab to chemotherapy in advanced NSCLC. PubMed, EMBASE, and Cochrane databases were searched. Eligible studies were randomized clinical trials (RCTs) that evaluated chemotherapy with or without bevacizumab in patients with advanced NSCLC. The outcomes included overall survival (OS), progression-free survival (PFS), response rate (RR), toxicities and treatment related mortality. Hazard ratios (HR) and odds ratios (OR) were used for the meta-analysis and were expressed with 95% confidence intervals (CI). We included results reported from five RCTs, with a total of 2,252 patients included in the primary analysis, all of them using platinum-based chemotherapy regimens. Compared to chemotherapy alone, the addition of bevacizumab to chemotherapy resulted in a significant longer OS (HR 0.89; 95% CI 0.79 to 0.99; p = 0.04), longer PFS (HR 0.73; 95% CI 0.66 to 0.82; p<0.00001) and higher response rates (OR 2.34; 95% CI 1.89 to 2.89; p<0.00001). We found no heterogeneity between trials, in all comparisons. There was a slight increase in toxicities in bevacizumab group, as well as an increased rate of treatment-related mortality. The addition of bevacizumab to chemotherapy in patients with advanced NSCLC prolongs OS, PFS and RR. Considering the toxicities added, and the small absolute benefits found, bevacizumab plus platinum-based chemotherapy can be considered an option in selected patients with advanced NSCLC. However, risks and benefits should be discussed with patients before decision making.
dc.description6
dc.descriptione22681
dc.languageeng
dc.relationPlos One
dc.relationPLoS ONE
dc.rightsaberto
dc.rights
dc.sourcePubMed
dc.subjectAntibodies, Monoclonal, Humanized
dc.subjectAntineoplastic Combined Chemotherapy Protocols
dc.subjectCarcinoma, Non-small-cell Lung
dc.subjectHumans
dc.subjectLung Neoplasms
dc.subjectRandomized Controlled Trials As Topic
dc.subjectSurvival Analysis
dc.titleAddition Of Bevacizumab To Chemotherapy In Advanced Non-small Cell Lung Cancer: A Systematic Review And Meta-analysis.
dc.typeArtículos de revistas


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