The Efficacy Of Bevacizumab In The Treatment Of Colorectal Cancer:A Meta-Analysis

Objective: To evaluate the efficacy and safety of bevacizumab in the treatment of colorectal cancer.Methods: Randomized controlled trials of bevacizumab for colorectal cancer from January 1,2003 to December 31,2018 were collected by searching Cochrane Library,PubMed and EMBASE databases.The primary endpoints were overall survival(OS),and the secondary endpoints were progression-free survival(PFS),Objective response rate(ORR)and adverse events.Two reviewers independently extract data.Revman 5.3 software provided by Cochrane Collaborative Network was used for data merging and statistical analysis.Results: According to the inclusion and exclusion criteria,17 studies were finally included.The 17 studies comprised 11354 cases in total,of which 5696 cases were from bevacizumab combined chemotherapy groups and 5658 from chemotherapy groups.15 studies were considered to be of high quality(4-6 points)and 2 study of low quality(1-3 points).Our Meta-analysis showed that the efficacy of bevacizumab in colorectal cancer patients included OS(HR:0.81;95%CI: 0.73-0.90,P<0.00001)?PFS(HR:0.73;95%CI: 0.65-0.82,P<0.00001)and ORR(OR:1.22;95%CI: 1.08-1.37,P=0.02).Regarding safety the incidence of adverse events was significantly higher than that of chemotherapy alone.The main causes were hypertension(OR:4.73,95%CI: 3.69-6.06,P<0.00001),bleeding(OR:2.96,95%CI:2.08-4.22,P<0.00001),proteinuria(OR:3.00,95%CI:1.93-4.67,P<0.00001),thrombosis(OR:1.58,95%CI:1.25-1.99,P=0.0001),gastrointestinal perforation(OR:2.93,95%CI:1.56-5.47,P=0.0008).However,the incidence of serious toxicity(> grade 3)is very low.There was no publication bias in the 17 reports included in this Meta-analysis.Conclusion: Bevacizumab combined with chemotherapy can provide significant survival advantages for patients with colorectal cancer.Bevacizumab combined with chemotherapy has low incidence of serious adverse events.And the overall tolerance,safety and effect are accepted in clinical work.