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A systematic review and meta-analysis on the effect of angiogenesis blockade for the treatment of gastric cancer

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单位: [1]Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Cancer Invasion and Metastasis Research and National Clinical Research Center for Digestive Diseases, Beijing 100050, People’s Republic of China
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关键词: anti-VEGF monoclonal antibody anti-VEGF receptor mAb VEGFR tyrosine kinase inhibitors Phase III trial overall survival progression-free survival chemotherapy

摘要:
Introduction: To date, anti-vascular endothelial growth factor (VEGF) monoclonal antibody (mAb, bevacizumab), anti-VEGF receptor mAb (ramucirumab) and selective vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (sunitinib, sorafenib and apatinib) have been tested in the clinical trials. Materials and methods: In the current study, results of 32 clinical trials (24 Phase I or II, 8 Phase III) were systematically reviewed and meta-analysis was performed in 8 Phase III trial results. Results: It was found that median overall survival (OS) time and progression-free survival (PFS) time were significantly longer in the patients treated with antiangiogenic reagents compared to that in the patients with placebo when all of 8 Phase III clinical trials were analyzed together (OS: odds ratio = 0.805, 95% CI: 0.719-0.901, P, 0.001; PFS: odds ratio = 0.719, 95% CI: 0.533-969, P = 0.030). Conclusion: Meta-analysis on bevacizumab (4 out 8 Phase III trials) indicated that neither OS nor PFS was significantly different between the groups treated with bevacizumab or placebo with or without combination of other chemotherapeutic reagents (OS: odds ratio = 0.909, 95% CI: 0.780-1.059, P = 0.221; PFS: odds ratio = 0.985, 95% CI: 0.865-1.122, P = 0.826). By contrast, meta-analysis on ramucirumab (3 out of 8 Phase III trials) revealed that ramucirumab was significantly favored in the treatment of gastric cancer with significant different OS between the two groups (odds ratio = 0.720, 95% CI: 0.604-0.858, P < 0.001). In addition, patients treated with VEGF or VEGFR blockers had higher morbidity of hypertension and neutropenia, but lower risk of side effects of vomiting and anemia. These findings suggest that addition of antiangiogenesis reagents, especially anti-VEGFR-mAb, to the first-or second-line chemotherapy could prolong patient's OS and PFS time in the advanced or metastatic gastric cancer.

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出版当年[2017]版:
大类 | 3 区 医学
小类 | 3 区 生物工程与应用微生物 4 区 肿瘤学
最新[2025]版:
大类 | 4 区 医学
小类 | 4 区 生物工程与应用微生物 4 区 肿瘤学
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出版当年[2016]版:
Q2 BIOTECHNOLOGY & APPLIED MICROBIOLOGY Q3 ONCOLOGY
最新[2023]版:
Q3 BIOTECHNOLOGY & APPLIED MICROBIOLOGY Q3 ONCOLOGY

影响因子: 最新[2023版] 最新五年平均[2021-2025] 出版当年[2016版] 出版当年五年平均[2012-2016] 出版前一年[2015版] 出版后一年[2017版]

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第一作者单位: [1]Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Cancer Invasion and Metastasis Research and National Clinical Research Center for Digestive Diseases, Beijing 100050, People’s Republic of China
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通讯机构: [1]Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Cancer Invasion and Metastasis Research and National Clinical Research Center for Digestive Diseases, Beijing 100050, People’s Republic of China [*1]Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Cancer Invasion and Metastasis Research and National Clinical Research Center for Digestive Diseases, 95 Yong-An Road, Xi-Cheng District, Beijing 100050, People’s Republic of China
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