Bevacizumab as First-line Therapy for Glioblastoma: A Meta-analysis

Objective To evaluate the effect and safety of multi-drug combination with bevacizumab as a first-line therapy for glioblastoma by evidence-based medicine method. Methods Eligible literatures were collected in PubMed, Embase, The Cochrane Library, China National Knowledge Infrastructure (CNKI) and China Biology Medicine disc (CBM). MetaAnalyst Beta 3.13 was used to analyze the data. Results Seventyeight relevant studies were searched, of which 12 studies were included with a total of 837 patients involved and 66 studies were excluded. Meta-analysis showed that pooled accuracy indicators like 6-month progression-free survival(PFS-6), PFS-12, 12-month overall survival(OS-12) and OS-24 were 84.5%(95% CI:78.1-89.3), 55.1%(95% CI:48.0-61.9), 76.0%(95% CI:62.5-85.7) and 38.4%(95% CI:32.5-44.7), respectively. The difference between radiotherapy-temozolomide-bevacizumab group and more drugs group had no statistical significance in PFS or OS. The common side effects included thrombocytopenia, thrombus/embolism, fatigue, stroke, granulopenia, infection, etc. There was no significant difference between adverse effects in different treatment groups. Conclusion Bevacizumab in combination with standard chemotherapy could prolong patients' PFS, but couldn't improve OS. Moreover, it couldn't significantly improve PFS or OS to add other drugs.