Efficacy and safety of bevacizumab combined with EGFR-TKIs in advanced non-small cell lung cancer: A meta-analysis.

BACKGROUND: The aim of this study was to estimate the efficacy and safety of bevacizumab combined with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) in advanced non-small cell lung cancer (NSCLC) patients. METHODS: We searched randomized controlled trials (RCTs) on bevacizumab combined with EGFR TKIs in the NSCLC Cochrane Library, Web of Science, PubMed and Embase. The data were extracted and assessed according to the Cochrane Handbook. We calculated the hazard ratio (HR), risk ratio (RR), and confidence interval (CI), and accomplished this meta-analysis with Stata 14 software. RESULTS: Of 1301 articles scanned, five articles were involved in this meta-analysis. We determined that compared with using EGFR TKIs alone, combination treatment significantly prolongs progression-free survival (PFS) (HR = 0.61, 95% CI = 0.52-0.70; p < 0.001), and increases the objective response rate (ORR) (RR = 1.15, 95% CI: 1.01-1.30, p = 0.10). However, there was no significant difference in overall survival (OS) between the two groups (HR = 0.95, 95% CI = 0.78-1.11; p = <0.001) and combination treatment increases the risks of serious adverse events (SAEs) (RR = 1.58, 95% CI: 1.21-2.05, p = 0.002). CONCLUSIONS: Bevacizumab combined with EGFR-TKI significantly improves PFS and ORR in patients with advanced NSCLC, but there is no substantial difference in OS and increase the risks of serious adverse events.