Efficacy and Safety of Bevacizumab-Combined Chemotherapy for Advanced and Recurrent Endometrial Cancer: A Systematic Review and Meta-Analysis.

BACKGROUND Bevacizumab-combined chemotherapy is a new regimen for advanced/recurrent endometrial cancer. AIMS This study aimed to evaluate the efficacy and safety of bevacizumab-combined chemotherapy in advanced/recurrent endometrial cancer. STUDY DESIGN This is a systematic review and meta-analysis of clinical trials. METHODS Eligible studies were retrieved form Embase, PubMed, and Cochrane Library. The data of primary outcomes including progression-free and overall survival and secondary outcomes including overall survival, response rate, and adverse events (grade ≥2) were extracted, pooled and used for the meta-analysis to compare the efficacy and safety of bevacizumab-combined chemotherapy versus other treatments in patients with advanced/recurrent endometrial cancer. RESULTS Two randomized-controlled and five single arm trials of bevacizumab-combined chemotherapy or bevacizumab single-agent therapy for endometrial cancer were included. Meta-analysis indicated that bevacizumab-combined chemotherapy significantly increased the progression-free survival rate (Hazards ratio, HR=0.82, 95% CI 0.70, 0.97) and overall survival rate (HR=0.83, 95% CI 0.70, 0.98) as compared with chemotherapy alone. The rates of overall, complete, and partial response to bevacizumab-combined chemotherapy were 76%, 22%, and 21%, respectively. The six and 12-month disease-free progression rate after bevacizumab-combined chemotherapy were 79% and 62%, respectively. Anemia (23%), leukopenia (46%), neutropenia (51%), hypertension (16%), and fatigue (24%) were the general adverse events following bevacizumab-combined chemotherapy. CONCLUSIONS This study suggested that bevacizumab-combined chemotherapy may have a higher efficacy in improving the overall and progression-free survival in patients with advanced/recurrent endometrial cancers as compared with chemotherapy alone.