title: An updated meta-analysis of fatal adverse events caused by bevacizumab therapy in cancer patients.
abstract: BACKGROUND
  The 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.
  
  
  METHODS
  An 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.
  
  
  RESULTS
  Thirty-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.
  
  
  CONCLUSIONS
  Compared 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.
authors.affiliation: Clinical Research Center, Affiliated Hospital of Guangdong Medical College, Zhanjiang, China.
authors.forename: Hongxin
authors.initials: H
authors.lastname: Huang
authors.affiliation: Department of Pharmacology, Guangdong Medical College, Zhanjiang, China.
authors.forename: Yayuan
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: Department of Pharmacology, Guangdong Medical College, Zhanjiang, China.
authors.forename: Jianhong
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Clinical Research Center, Affiliated Hospital of Guangdong Medical College, Zhanjiang, China.
authors.forename: Jingjing
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Clinical Research Center, Affiliated Hospital of Guangdong Medical College, Zhanjiang, China.
authors.forename: Huapu
authors.initials: H
authors.lastname: Chen
authors.affiliation: Clinical Research Center, Affiliated Hospital of Guangdong Medical College, Zhanjiang, China.
authors.forename: Xinggui
authors.initials: X
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; D018572:Disease-Free Survival; D006470:Hemorrhage / Q000139:chemically induced* / Q000401:mortality; D006801:Humans; D009026:Mortality; D009369:Neoplasms / Q000188:drug therapy* / Q000401:mortality; D016032:Randomized Controlled Trials as Topic; D012306:Risk
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab