Efficacy and Safety of Bevacizumab Biosimilars Compared With Reference Biologics in Advanced Non-small Cell Lung Cancer or Metastatic Colorectal Cancer Patients: A Network Meta-Analysis

Abstract

Background: Bevacizumab biosimilars are slowly making their way into cancer treatment, but the data on their efficacy and safety in cancer patients are still poor. We systematically summarized the current evidence for the efficacy and safety of bevacizumab biosimilars in patients with advanced non-small cell lung cancer (NSCLC) or metastatic colorectal cancer (CRC).Methods: This review searched CNKI, VIP, PubMed, Medline (Ovid), Embase, and Cochrane Library (Ovid) for randomized controlled trials of bevacizumab biosimilars treated in adults with advanced NSCLC or metastatic CRC. A pairwise meta-analysis and a Bayesian network meta-analysis based on the random-effect model were performed to summarize the evidence. We rated the certainty of evidence according to the Grading of Recommendations Assessment, Development, and Evaluation framework.Results: Ten eligible trials with a total of 5526 patients were included. Seven trials (n = 4581) were for the NSCLC population, while three trials (n = 945) were for patients with CRC. According to the pairwise meta-analysis, the efficacy (objective response rate: risk ratio (RR) 0.98 [0.92–1.04], p = 0.45; progression-free survival: hazard ratio (HR) 1.01 [0.92–1.10], p = 0.85; and overall survival: HR 1.06 [0.94–1.19], p = 0.35) and safety (incidence of grade 3–5 adverse events: odds ratio (OR) 1.03 [0.91–1.16], p = 0.65) of bevacizumab biosimilars performed no significant difference with reference biologics in patients with NSCLC as well as metastatic CRC patients (objective response rate: RR 0.97 [0.87–1.09], p = 0.60; overall survival: HR 0.94 [0.70–1.25], p = 0.66; incidence of grade 3–5 adverse events: OR 0.78 [0.59–1.02], p = 0.73). Network estimates displayed 7 types of bevacizumab biosimilars in the medication regime of NSCLC patients who had no significant difference among each other in terms of efficacy and safety. The certainty of the evidence was assessed as low to moderate. Three types of biosimilars were found to be clinically equivalent to each other in the patients with CRC, which were evaluated with very low to moderate certainty.Conclusion: In patients with advanced NSCLC or metastatic CRC, the efficacy and safety of bevacizumab biosimilars were found to be comparable with those of reference biologics and each other.

Evaluation of bevacizumab biosimilar on wound healing complications in patients with colorectal cancer undergoing endoscopic mucosal resection: A systematic review and meta‐analysis in anorectal medicine

“…It was revealed that efficacy and safety profiles of bevacizumab biosimilars closely resembled those of the reference biologics for NSCLC and CRC patients with metastatic disease. Intriguingly, the various varieties of bevacizumab biosimilars exhibited negligible differences in terms of their therapeutic efficacy and safety 12 …”

“…The focus is on understanding how this biosimilar impacts wound healing, considering that Bevacizumab's mechanism of inhibiting vascular endothelial growth factor (VEGF) could potentially impede this process. This evaluation is crucial to determine if the biosimilar offers similar or improved outcomes compared with the original Bevacizumab, including its effects on wound healing rates and adverse effects, as well as its cost‐effectiveness in clinical practice 8–12 …”

“…Complications during the healing of wounds have the potential to greatly affect patient outcomes by extending the recovery process and possibly necessitating further medical interventions 11 . This is particularly significant in the field of anatomical medicine, where surgical procedures are frequently performed and proficient wound care is vital for the recuperation and well‐being of patients 12,13 …”

“…11 This is particularly significant in the field of anatomical medicine, where surgical procedures are frequently performed and proficient wound care is vital for the recuperation and well-being of patients. 12,13 The primary objective of this meta-analysis was to address this knowledge deficit through assessment of safety and effectiveness of Bevacizumab Biosimilar Plus in relation to wound healing in patients with CRC.…”

Integration of artificial intelligence in lung cancer: Rise of the machine

“… 73 The Bayesian network approach helps address this issue by producing novel outputs such as treatment rankings, odds ratios, and probability distributions. 74 Several such studies have been performed in lung cancer, including evaluating safety and efficacy of bevacizumab biosimilars, 75 determining optimal platinum-based chemotherapy for early-stage resected NSCLC, 76 how smoking status influences effect of targeted therapy, 77 and choice of first-line treatment for patients on the basis of PD-L1 expression. 78 , 79 , 80 …”