An Updated Meta-Analysis of Fatal Adverse Events Caused by Bevacizumab Therapy in Cancer Patients

Abstract

BackgroundThe risk of fatal adverse events (FAEs) due to bevacizumab-based chemotherapy has not been well described; we carried out an updated meta-analysis regarding this issue.MethodsAn electronic search of Medline, Embase and The Cochrane Central Register of Controlled Trials was conducted to investigate the effects of randomized controlled trials on bevacizumab treatment on cancer patients. Random or fixed-effect meta-analytical models were used to evaluate the risk ratio (RR) of FAEs due to the use of bevacizumab.ResultsThirty-four trials were included. Allocation to bevacizumab therapy significantly increased the risk of FAEs; the RR was 1.29 (95% CI:1.05–1.57). This association varied significantly with tumor types (P = 0.002) and chemotherapeutic agents (P = 0.005) but not with bevacizumab dose (P = 0.90). Increased risk was seen in patients with non–small cell lung cancer, pancreatic cancer, prostate cancer, and ovarian cancer. However, FAEs were lower in breast cancer patients treated with bevacizumab. In addition, bevacizumab was associated with an increased risk of FAEs in patients who received concomitant agents of taxanes and/or platinum.ConclusionCompared with chemotherapy alone, the addition of bevacizumab was associated with an increased risk of FAEs among patients with special tumor types, particularly when combined with chemotherapeutic agents such as platinum.

Expression of cluster of differentiation 34 and vascular endothelial growth factor in breast cancer, and their prognostic significance

“…However, the administration of bevacizumab combined with paclitaxel for the treatment of metastatic breast cancer is still retained in the American National Comprehensive Cancer Network Guide (26). In addition, it is still widely applied in the treatment of colon cancer, lung cancer, glioblastoma, renal cell carcinoma and other tumors (4,27).…”

A Real-Life Experience of Bevacizumab in Elderly Women With Advanced Ovarian Carcinoma

“…7 Arterial thrombotic events, severe hemorrhage, and gastrointestinal perforation are also rare but are the main causes of BEVA-induced fatal adverse events. 8 The latter is even more of a concern in ovarian cancer patients because it appears more frequently in patients with heavily pretreated serous peritoneal carcinoma and/or bowel obstruction. 8,9 The tolerance of anticancer agents in older patients, especially BEVA, is an increasing concern of the oncology community given the growing age of the general population.…”

“…8 The latter is even more of a concern in ovarian cancer patients because it appears more frequently in patients with heavily pretreated serous peritoneal carcinoma and/or bowel obstruction. 8,9 The tolerance of anticancer agents in older patients, especially BEVA, is an increasing concern of the oncology community given the growing age of the general population. Prospective data are lacking because elderly patients are still underrepresented in clinical trials.…”

New ways to successfully target tumor vasculature in ovarian cancer

“…The most common adverse events(AEs) were neutropenia, leukopenia, hypertension, fatigue, nausea, proteinuria and even fatal gastrointestinal perforation[22, 23]. A history of treatment for inflammatory bowel disease (IBD), or bowel resection at primary surgery was found to increase the odds of gastrointestinal AEs[24].…”