Efficacy and safety of intrapleural combination therapy with bevacizumab and chemotherapeutic agents for lung cancer-mediated malignant pleural effusion: a meta-analysis

Objective To systematically review the efficacy and safety of intrapleural injection of Bevacizumab combined with chemotherapeutic agents in treatment of lung cancer with malignant pleural effusion. Methods Databases including PubMed, The Cochrane Library, EMbase, Web of Science, CNKI, VIP and WanFang Data were searched to collect randomized controlled trials (RCTs) about Bevacizumab combined with chemotherapeutic agents for lung cancer-mediated malignant pleural effusion from 2000 to February 2017. Overall response rates, main adverse effects incidence, relative risk(RR) were calculated. Then meta-analysis was performed by RevMan 5.3 and stata 12.0 software. Results A total of 8 RCTs involving 510 patients were finally included. The results of Meta analysis showed that: the overall response rate in the Bevacizumab combined with chemotherapeutic agents group were higher than that of the conventional chemotherapeutic agents alone group (RR=1.43, 95% CI 1.27 to 1.62, P 0.05). Conclusions Compared with chemotheraputic agents, intrapleural injection of Bevacizumab combined with chemotherapeutic agents can improve the overall response rate without increasing incidence of main adverse reaction. Key words: Bevacizumab; Lung cancer; Malignant pleural effusion; Meta-analysis; Randomized controlled trial