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Efficacy of bevacizumab combined with erlotinib for advanced hepatocellular carcinoma: a single-arm meta-analysis based on prospective studies

BACKGROUND: The efficacy of bevacizumab combined with erlotinib (B + E) for the treatment of advanced hepatocellular carcinoma, especially for sorafenib-refractory patients, has been observed and evaluated in several trials. We conducted this single arm meta-analysis to generally assess the benefit...

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Autores principales: He, Liyun, Deng, Huan, Lei, Jun, Yi, Fengming, Li, Jine, Fan, Xiu De, Wei, Yiping, Xu, Jianjun, Zhang, Wenxiong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6437948/
https://www.ncbi.nlm.nih.gov/pubmed/30922256
http://dx.doi.org/10.1186/s12885-019-5487-6
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author He, Liyun
Deng, Huan
Lei, Jun
Yi, Fengming
Li, Jine
Fan, Xiu De
Wei, Yiping
Xu, Jianjun
Zhang, Wenxiong
author_facet He, Liyun
Deng, Huan
Lei, Jun
Yi, Fengming
Li, Jine
Fan, Xiu De
Wei, Yiping
Xu, Jianjun
Zhang, Wenxiong
author_sort He, Liyun
collection PubMed
description BACKGROUND: The efficacy of bevacizumab combined with erlotinib (B + E) for the treatment of advanced hepatocellular carcinoma, especially for sorafenib-refractory patients, has been observed and evaluated in several trials. We conducted this single arm meta-analysis to generally assess the benefit and risk with B + E for advanced hepatocellular carcinoma. METHODS: The PubMed, Cochrane Library, Embase, ScienceDirect, Web of Science and Scopus databases were searched for related studies. The main outcomes were objective response rate (ORR), disease control rate (DCR), overall survival (OS), progression-free survival (PFS) and adverse effects (AEs). RESULTS: Eight phase II clinical trials including 342 hepatocellular carcinoma patients were analyzed. The pooled ORR was 12.6% (95% CI: 6.3–19.0%), and the pooled DCR was 54.5% (95% CI: 48.9–66.8%). The 16-week PFS rate was 50.2% (95% CI: 38.2–62.2%). The 6- and 12-month OS rates were 77.8% (95% CI: 71.3–84.2%) and 44.9% (95% CI: 36.8–53.0%). The main grade 3–4 AEs were fatigue (11.9%), diarrhea (9.0%), hypertension (6.7%), acne (5.8%) and hemorrhage (5.3%). The only RCT showed that the B + E regimen had a consistent response and equable median OS but fewer toxicities (grade 3–4 AEs: 19% vs. 27%) than sorafenib. Subgroup analysis showed that as a second-line treatment, the B + E regimen had substantial value with a favorable PFS-16w (P = 0.012), OS-12 m (P = 0.048) and a favorable tendency of ORR (P = 0.089), but obvious toxicities in the second-line setting could not be neglected. CONCLUSION: Bevacizumab combined with erlotinib is effective for treating hepatocellular carcinoma patients, especially sorafenib-refractory patients. More well-designed and large-scale RCTs are warranted to prove our findings. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12885-019-5487-6) contains supplementary material, which is available to authorized users.
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spelling pubmed-64379482019-04-08 Efficacy of bevacizumab combined with erlotinib for advanced hepatocellular carcinoma: a single-arm meta-analysis based on prospective studies He, Liyun Deng, Huan Lei, Jun Yi, Fengming Li, Jine Fan, Xiu De Wei, Yiping Xu, Jianjun Zhang, Wenxiong BMC Cancer Research Article BACKGROUND: The efficacy of bevacizumab combined with erlotinib (B + E) for the treatment of advanced hepatocellular carcinoma, especially for sorafenib-refractory patients, has been observed and evaluated in several trials. We conducted this single arm meta-analysis to generally assess the benefit and risk with B + E for advanced hepatocellular carcinoma. METHODS: The PubMed, Cochrane Library, Embase, ScienceDirect, Web of Science and Scopus databases were searched for related studies. The main outcomes were objective response rate (ORR), disease control rate (DCR), overall survival (OS), progression-free survival (PFS) and adverse effects (AEs). RESULTS: Eight phase II clinical trials including 342 hepatocellular carcinoma patients were analyzed. The pooled ORR was 12.6% (95% CI: 6.3–19.0%), and the pooled DCR was 54.5% (95% CI: 48.9–66.8%). The 16-week PFS rate was 50.2% (95% CI: 38.2–62.2%). The 6- and 12-month OS rates were 77.8% (95% CI: 71.3–84.2%) and 44.9% (95% CI: 36.8–53.0%). The main grade 3–4 AEs were fatigue (11.9%), diarrhea (9.0%), hypertension (6.7%), acne (5.8%) and hemorrhage (5.3%). The only RCT showed that the B + E regimen had a consistent response and equable median OS but fewer toxicities (grade 3–4 AEs: 19% vs. 27%) than sorafenib. Subgroup analysis showed that as a second-line treatment, the B + E regimen had substantial value with a favorable PFS-16w (P = 0.012), OS-12 m (P = 0.048) and a favorable tendency of ORR (P = 0.089), but obvious toxicities in the second-line setting could not be neglected. CONCLUSION: Bevacizumab combined with erlotinib is effective for treating hepatocellular carcinoma patients, especially sorafenib-refractory patients. More well-designed and large-scale RCTs are warranted to prove our findings. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12885-019-5487-6) contains supplementary material, which is available to authorized users. BioMed Central 2019-03-28 /pmc/articles/PMC6437948/ /pubmed/30922256 http://dx.doi.org/10.1186/s12885-019-5487-6 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
He, Liyun
Deng, Huan
Lei, Jun
Yi, Fengming
Li, Jine
Fan, Xiu De
Wei, Yiping
Xu, Jianjun
Zhang, Wenxiong
Efficacy of bevacizumab combined with erlotinib for advanced hepatocellular carcinoma: a single-arm meta-analysis based on prospective studies
title Efficacy of bevacizumab combined with erlotinib for advanced hepatocellular carcinoma: a single-arm meta-analysis based on prospective studies
title_full Efficacy of bevacizumab combined with erlotinib for advanced hepatocellular carcinoma: a single-arm meta-analysis based on prospective studies
title_fullStr Efficacy of bevacizumab combined with erlotinib for advanced hepatocellular carcinoma: a single-arm meta-analysis based on prospective studies
title_full_unstemmed Efficacy of bevacizumab combined with erlotinib for advanced hepatocellular carcinoma: a single-arm meta-analysis based on prospective studies
title_short Efficacy of bevacizumab combined with erlotinib for advanced hepatocellular carcinoma: a single-arm meta-analysis based on prospective studies
title_sort efficacy of bevacizumab combined with erlotinib for advanced hepatocellular carcinoma: a single-arm meta-analysis based on prospective studies
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6437948/
https://www.ncbi.nlm.nih.gov/pubmed/30922256
http://dx.doi.org/10.1186/s12885-019-5487-6
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