Bevacizumab and Breast Cancer A Meta-Analysis of First-Line Phase III Studies and a Critical Reappraisal of Available Evidence英文文献资料.docVIP

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Bevacizumab and Breast Cancer A Meta-Analysis of First-Line Phase III Studies and a Critical Reappraisal of Available Evidence英文文献资料.doc

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Bevacizumab and Breast Cancer A Meta-Analysis of First-Line Phase III Studies and a Critical Reappraisal of Available Evidence英文文献资料

HindawiPublishingCorporation JournalofOncology Volume2012,ArticleID417673,8pages doi:10.1155/2012/417673 ResearchArticle BevacizumabandBreastCancer:AMeta-AnalysisofFirst-Line PhaseIIIStudiesandaCriticalReappraisalofAvailableEvidence Jos′eR.Rossari, 1 OttoMetzger-Filho, 1 MariannePaesmans, 1 KamalS.Saini, 1 AlessandraGennari, 2 EvandrodeAzambuja, 1 andMartinePiccart-Gebhart 1 1 2 InstitutJulesBordet,Universit′eLibredeBruxelles,BoulevarddeWaterloo,125,1000Brussels,Belgium MedicalOncology,GallieraHospital,ViaVolta6,16125Genoa,Italy CorrespondenceshouldbeaddressedtoMartinePiccart-Gebhart,martine.picart@bordet.be Received4May2012;Accepted1August2012 AcademicEditor:MaryamLustberg Copyright?2012Jos′eR.Rossarietal.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttributionLicense, whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperlycited. Background.Randomizedstudieshaveshowndi?erentmagnitudeofbevacizumabbene?tinthetreatmentofadvancedbreast cancer.Regulatoryagencieshavemodi?edbevacizumabtreatmentindicationsacrossdi?erentregions.Inthisstudy,weperforma meta-analysisofphaseIIIstudiesaimingtointerrogatethemagnitudeofbevacizumabbene?tforthetreatmentof?rst-lineHER2- negativemetastaticbreastcancer(MBC).Methods.DatafromstudiesE2100,AVADOandRIBBON-1wereusedtocalculatethe bene?tofbevacizumabintermsoftumoroverallresponserate(ORR),progression-freesurvival(PFS),overallsurvival(OS),and toxicities.Combinedstatisticalestimatesofhazardratios(HR)andoddsratioswerecalculatedusing?xed-e?ectsorrandom- e?ectsmodels.Results.Atotalof2,695patientswereevaluated.Combiningbevacizumabwithdi?erentchemotherapybackbones resultedina30%riskreductionofPFSevents(HR=0.70;95%con?denceinterval[CI],0.57–0.86)andincreasedORR(odds ratio1.81;95%CI,1.53–2.14).NoOSbene?tcouldbedemonstrated(HR=0.95;95%CI,0.85–1.06).Bevacizumabsigni?cantly increasedtheincidenceofadverseeventssuchasproteinuria,hypertensionandcardiovascularevents.Conclusions .Bevacizumab combinedw