title: Efficacy and toxicity of bevacizumab in recurrent ovarian disease: an update meta-analysis on phase III trials.
abstract: BACKGROUND
  To analyze the efficacy and toxicity of bevacizumab on survival outcomes in recurrent ovarian cancer.
  
  
  RESULTS
  Bevacizumab was associated with significant improvement of PFS and OS compared with standard treatment with HRs of 0.53 (95% CI 0.44 - 0.63; p < 0.00001) and 0.87 (95% CI, 0.77 to 0.99; p = 0.03), respectively.Bevacizumab increased the incidence of G3/G4 hypertension (RR 19.01, 95% CI 7.77 - 46.55; p < 0.00001), proteinuria (RR 17.31, 95% CI 5.42 - 55.25; p < 0.00001), arterial thromboembolic events (ATE) (RR 4.99, 95% CI 1.29 - 19.27; p = 0.02) and bleeding (RR 3.14, 95% CI 1.35 - 7.32; p = 0.008).
  
  
  METHODS
  Three randomized phase III trials representing 1502 patients were identified.Pooled hazard ratio (HR), odd ratio (OR), risk ratio (RR) with 95% confidence interval (CI) were calculated using fixed or random effects model.
  
  
  CONCLUSIONS
  Adding bevacizumab to standard chemotherapy improved ORR, PFS and OS, and it had a higher, but manageable, incidence of toxicities graded 3 to 4.
authors.affiliation: Department of Obstetrics-Gynecological Sciences and Urological Sciences, Policlinico Umberto I "Sapienza" University of Rome, Viale del Policlinico, Rome 00161, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Marchetti
authors.affiliation: Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Viale Regina Elena, Rome 00161, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: De Felice
authors.affiliation: Department of Obstetrics-Gynecological Sciences and Urological Sciences, Policlinico Umberto I "Sapienza" University of Rome, Viale del Policlinico, Rome 00161, Italy.
authors.forename: Innocenza
authors.initials: I
authors.lastname: Palaia
authors.affiliation: Department of Obstetrics-Gynecological Sciences and Urological Sciences, Policlinico Umberto I "Sapienza" University of Rome, Viale del Policlinico, Rome 00161, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Musella
authors.affiliation: Department of Obstetrics-Gynecological Sciences and Urological Sciences, Policlinico Umberto I "Sapienza" University of Rome, Viale del Policlinico, Rome 00161, Italy.
authors.forename: Violante
authors.initials: V
authors.lastname: Di Donato
authors.affiliation: Department of Obstetrics-Gynecological Sciences and Urological Sciences, Policlinico Umberto I "Sapienza" University of Rome, Viale del Policlinico, Rome 00161, Italy.
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Gasparri
authors.affiliation: Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Viale Regina Elena, Rome 00161, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Musio
authors.affiliation: Department of Obstetrics-Gynecological Sciences and Urological Sciences, Policlinico Umberto I "Sapienza" University of Rome, Viale del Policlinico, Rome 00161, Italy.
authors.forename: Ludovico
authors.initials: L
authors.lastname: Muzii
authors.affiliation: Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Viale Regina Elena, Rome 00161, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Tombolini
authors.affiliation: Department of Obstetrics-Gynecological Sciences and Urological Sciences, Policlinico Umberto I "Sapienza" University of Rome, Viale del Policlinico, Rome 00161, Italy.
authors.forename: Pierluigi Benedetti
authors.initials: PB
authors.lastname: Panici
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000627:therapeutic use*; D000077216:Carcinoma, Ovarian Epithelial; D017326:Clinical Trials, Phase III as Topic; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D009375:Neoplasms, Glandular and Epithelial / Q000188:drug therapy* / Q000401:mortality; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D000068258:Bevacizumab
keywords: bevacizumab; ovarian cancer; recurrent; survival; toxicity