The prognostic significance of anti-angiogenesis therapy in ovarian cancer: a meta-analysis

OBJECTIVE: The prognostic value of anti-angiogenesis therapy in ovarian cancer patients is currently under debate. In this study, we assessed the effects of anti-angiogenesis therapy on the progression free survival (PFS) and overall survival (OS) of ovarian cancer patients. MATERIALS AND METHODS: PubMed was searched to identify relevant studies that evaluated the therapeutic value of anti-angiogenic agents in ovarian cancer (the final search was current to Dec. 13th 2014). Reviews of each study were conducted, and the data were extracted. The primary outcomes that were analysed were progression free survival (PFS) and overall survival (OS). The pooled hazard ratio (HR) and 95 % confidence intervals (CIs) were calculated using the random and fixed-effects models, and subgroup and sensitivity analyses were subsequently performed. RESULTS: A total of 12 studies were included in the meta-analysis. The overall analysis revealed that the incorporation of anti-angiogenesis therapy was significantly associated with a longer PFS (HR, 0.66; 95 % CI, 0.58-0.75; P < 0.01) and a longer OS (HR, 0.89; 95 % CI, 0.82-0.97; P = 0.01) in the total population, and these findings were confirmed by one-way sensitivity analyses. Further subgroup analyses demonstrated that the administrations of each of the agents were associated with improved PFSs. The prognostic value of anti-angiogenesis therapy for the OS was significant in the trebananib subgroup (HR, 0.81; 95 % CI, 0.67-0.99; P = 0.04). The bevacizumab subgroup exhibited a similar trend that did not reach statistical significance (HR, 0.90; 95 % CI, 0.80-1.01; P = 0.08). CONCLUSIONS: The present meta-analysis indicated that anti-angiogenesis therapy in ovarian cancer patients was associated with a better clinical outcome. Further studies are warranted to identify the specific subgroup of patients who are most likely to benefit from anti-angiogenesis therapy.