Meta-analysis of efficacy and safety of bevacizumab combined with lomustine in treatment of recurrent glioblastoma

DING Xiurong; LIU Jinlong; HUANG Shengxuan; LI Zhihong

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Medical Journal of the Chinese People Armed Police Forces ›› 2024, Vol. 35 ›› Issue (2) : 150-156.

Meta-analysis of efficacy and safety of bevacizumab combined with lomustine in treatment of recurrent glioblastoma

DING Xiurong¹, LIU Jinlong², HUANG Shengxuan³, LI Zhihong¹

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Abstract

Objective To systematically evaluate the clinical efficacy and safety of bevacizumab combined with lomustine in the treatment of recurrent glioma.Methods A comprehensive computer search was conducted in both Chinese and English databases to search randomized controlled trials on the use of bevacizumab in combination with lomustine in patients with recurrent glioma. The search time was from the establishment of the database to April 2023. Two researchers independently searched the database, screened the literature, extracted and analyzed the data, analyzed the risk of bias in the included literature, and performed a meta-analysis using software (RevMan 5.4).Results Six randomized controlled trials were included, with a total of 1053 patients (523 in experimental group and 530 in control group). The results of Meta analysis showed that bevacizumab combined with lomustine significantly improved progression-free survival (PFS)(HR=0.52,95%CI:0.44-0.61,P<0.05)and Objective response rate (ORR)(OR=0.33,95%CI:0.14-0.78, P<0.05)in patients with recurrent glioblastoma, and had no significant on overall survival (OS)(HR=0.89,95%CI:0.75-1.07, P<0.05). In terms of adverse reactions: the incidence of proteinuria and grade Ⅲ or above adverse reactions in bevasizumab combined with lomustine was significantly higher than that in the control group, with statistical significance (P<0.05), while there was no statistical significance in other adverse reactions compared with the control group.Conclusions Bevacizumab combined with Lomustine can significantly improve PFS and ORR in patients with recurrent GBM, indicating that the combination therapy is recommended for the treatment of recurrent glioblastoma. At the same time, the combination of bevacizumab and lomustine is also associated with an increased rate of proteinuria and grade III or higher adverse reactions, so safety needs to be considered before adding bevacizumab to the lomustine regimen.

Key words

recurrent glioblastoma / bevacizumab / lomustine

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DING Xiurong, LIU Jinlong, HUANG Shengxuan, LI Zhihong. Meta-analysis of efficacy and safety of bevacizumab combined with lomustine in treatment of recurrent glioblastoma[J]. Medical Journal of the Chinese People Armed Police Forces. 2024, 35(2): 150-156

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