title: Bevacizumab in the treatment of ovarian cancer: a meta-analysis from four phase III randomized controlled trials.
abstract: BACKGROUND
  The aim of this meta-analysis was to summarize the efficacy and safety of bevacizumab in the treatment of ovarian cancer.
  
  
  METHODS
  We sought to identify randomised controlled trials (RCTs) by searching PubMed and Web of Science. Outcomes were objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and adverse events.
  
  
  RESULTS
  Four studies with 4,246 patients were included. Combination of bevacizumab and chemotherapy resulted in a statistically significant improvement in ORR (OR 2.165, 95 % CI 1.511-3.103) and in PFS (HR 0.691, 95 % CI 0.517-0.865), compared with chemotherapy alone. There was no evidence of a significant improvement in OS (HR 0.934, 95 % CI 0.826-1.041). It also had significantly increased risk of gastrointestinal events (OR 2.743, 95 % CI 1.580-4.763; P < 0.001), hypertension (OR 4.630, 95 % CI 3.737 to 5.737; P < 0.001), proteinuria (OR 4.872, 95 % CI 2.617-9.069; P < 0.001), and arterial thromboembolism (OR 1.994, 95 % CI 1.210-3.286; P = 0.007).
  
  
  CONCLUSIONS
  This meta-analysis suggests that the addition of bevacizumab to chemotherapy offers meaningful improvement in objective response rate and progression-free survival in ovarian cancer treatment, but does not benefit overall survival. It also significantly increased the occurrence of gastrointestinal events, hypertension, proteinuria, and arterial thromboembolism.
authors.affiliation: Department of Obstetrics and Gynecology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, People's Republic of China. pphss@126.com
authors.forename: Qing
authors.initials: Q
authors.lastname: Ye
authors.forename: Hong-Lin
authors.initials: HL
authors.lastname: Chen
mesh_terms: D020533:Angiogenesis Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use*; D000068258:Bevacizumab; D017326:Clinical Trials, Phase III as Topic; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality; D016032:Randomized Controlled Trials as Topic
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab