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

Zhi-Gang Bai, Zhong-Tao Zhang 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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Main Authors: Bai ZG, Zhang ZT
Format: Article
Language:English
Published: Dove Medical Press 2018-10-01
Series:OncoTargets and Therapy
Subjects:
Online Access:https://www.dovepress.com/a-systematic-review-and-meta-analysis-on-the-effect-of-angiogenesis-bl-peer-reviewed-article-OTT
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spelling doaj-089aac1513684cc595950863e82b35452020-11-24T23:56:30ZengDove Medical PressOncoTargets and Therapy1178-69302018-10-01Volume 117077708741529A systematic review and meta-analysis on the effect of angiogenesis blockade for the treatment of gastric cancerBai ZGZhang ZTZhi-Gang Bai, Zhong-Tao Zhang 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 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. Keywords: anti-VEGF monoclonal antibody, anti-VEGF receptor mAb, VEGFR tyrosine kinase inhibitors, Phase III trial, overall survival, progression-free survival, chemotherapyhttps://www.dovepress.com/a-systematic-review-and-meta-analysis-on-the-effect-of-angiogenesis-bl-peer-reviewed-article-OTTanti-VEGF monoclonal antibodyanti-VEGF receptor mAbVEGFR tyrosine kinase inhibitorsphase III trialoverall survivalprogress free survivalchemotherapy
collection DOAJ
language English
format Article
sources DOAJ
author Bai ZG
Zhang ZT
spellingShingle Bai ZG
Zhang ZT
A systematic review and meta-analysis on the effect of angiogenesis blockade for the treatment of gastric cancer
OncoTargets and Therapy
anti-VEGF monoclonal antibody
anti-VEGF receptor mAb
VEGFR tyrosine kinase inhibitors
phase III trial
overall survival
progress free survival
chemotherapy
author_facet Bai ZG
Zhang ZT
author_sort Bai ZG
title A systematic review and meta-analysis on the effect of angiogenesis blockade for the treatment of gastric cancer
title_short A systematic review and meta-analysis on the effect of angiogenesis blockade for the treatment of gastric cancer
title_full A systematic review and meta-analysis on the effect of angiogenesis blockade for the treatment of gastric cancer
title_fullStr A systematic review and meta-analysis on the effect of angiogenesis blockade for the treatment of gastric cancer
title_full_unstemmed A systematic review and meta-analysis on the effect of angiogenesis blockade for the treatment of gastric cancer
title_sort systematic review and meta-analysis on the effect of angiogenesis blockade for the treatment of gastric cancer
publisher Dove Medical Press
series OncoTargets and Therapy
issn 1178-6930
publishDate 2018-10-01
description Zhi-Gang Bai, Zhong-Tao Zhang 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 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. Keywords: anti-VEGF monoclonal antibody, anti-VEGF receptor mAb, VEGFR tyrosine kinase inhibitors, Phase III trial, overall survival, progression-free survival, chemotherapy
topic anti-VEGF monoclonal antibody
anti-VEGF receptor mAb
VEGFR tyrosine kinase inhibitors
phase III trial
overall survival
progress free survival
chemotherapy
url https://www.dovepress.com/a-systematic-review-and-meta-analysis-on-the-effect-of-angiogenesis-bl-peer-reviewed-article-OTT
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