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The prognosis for patients with newly diagnosed glioblastoma receiving bevacizumab combination therapy: a meta-analysis

Authors Liao KL, Huang S, Wu YP

Received 10 November 2017

Accepted for publication 20 February 2018

Published 19 June 2018 Volume 2018:11 Pages 3513—3520

DOI https://doi.org/10.2147/OTT.S156723

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Ms Justinn Cochran

Peer reviewer comments 5

Editor who approved publication: Dr Yao Dai


Ke-Li Liao,1 Song Huang,1 Yu-Peng Wu2

1Department of Neurosurgery, Zigong First People’s Hospital, Zigong, Sichuan, People’s Republic of China; 2Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China

Background: A combination of temozolomide (TMZ) and radiotherapy and subsequent adjuvant chemotherapy is the gold standard of treatment for glioblastoma (GB). Bevacizumab (BEV), a humanized monoclonal antibody that blocks the effects of vascular endothelial growth factor A, has produced impressive response rates for recurrent GB and has been approved as second-line therapy. The efficacy and safety of BEV in newly diagnosed GB are not known.
Aim: This systematic meta-analysis was undertaken to evaluate the value of combination therapy involving BEV in newly diagnosed GB.
Methods: Electronic databases were searched for eligible literature up to October 2017. Randomized controlled trials assessing the efficacy and safety of BEV in patients with newly diagnosed GB were included, of which the main outcomes were progression-free survival (PFS), overall survival (OS), and adverse events (AEs). All the data were pooled with the corresponding 95% confidence intervals (CIs) using RevMan software. Sensitivity analyses and heterogeneity were quantitatively evaluated.
Results: A total of six randomized controlled trials were included in this analysis. The experimental BEV group had significantly improved the overall PFS (OR =0.46, 95% CI =0.26–0.81, P=0.007), as well as PFS at 6 months (OR =3.47, 95% CI =2.85–4.22, P<0.00001) and PFS at 12 months (OR =2.02, 95% CI =1.66–2.46, P<0.00001), respectively. However, there were no significant differences in PFS at 24 months with BEV (OR =0.95, 95% CI =0.61–1.48, P=0.82). OS at 6 months (P=0.07) and 24 months (P=0.07) was not significantly improved with BEV in patients with newly diagnosed GB. However, the meta-analysis on the OS at 12 months showed differences with BEV (OR =1.24, 95% CI =1.03–1.50, P=0.02).
Conclusion: Our study indicates that addition of BEV for newly diagnosed GB resulted in a superior PFS rate. However, the combination therapy involving BEV did not improve OS. Future investigations are needed to analyze whether BEV helps improve OS efficacy.

Keywords:
bevacizumab, glioblastoma, newly diagnosed, meta-analysis, neoadjuvant

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