EFFICACY AND SAFETY OF BEVACIZUMAB PLUS CHEMOTHERAPY VERSUS CHEMOTHERAPY ALONE IN THE TREATMENT OF NON-SMALL-CELL LUNG CANCER IN ASIAN PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS

the treatments available to patients with metastatic or locally advanced non-small cell lung cancer (NSCLC). The objective of this review is to evaluate the efficacy and safety of bevacizumab plus chemotherapy versus chemotherapy alone for the treatment of NSCLC in Asian patients. METHODS: All randomized controlled trials (RCTs) examining the efficacy and safety of bevacizumab plus chemotherapy in adult patients with histologically confirmed NSCLC in Asian patients were included. We looked into overall survival (OS) and progression free survival (PFS) as the primary outcomes. Secondary outcomes were response rate, complete response, partial response, stable disease, progressive disease, disease control, and adverse events. Literature searches were conducted in MEDLINE and the Cochrane Library. In addition, references of included studies and clinicaltrials. gov were searched for relevant studies. No language or date restrictions were imposed. Study quality of included trials were assessed using the Cochrane Risk of Bias Tool. Two authors independently selected papers, extracted data and assessed quality. RESULTS: Four RCTs involving a total of 652 patients were included in this meta-analysis. The combination of bevacizumab with carboplatin & paclitaxel (BCP regimen) showed improved response rate (RR=1.87, 95% CI 1.50 to 2.30) and improved clinical benefit (RR=1.16, 95% CI 0.96 to 1.39) when compared to CP regimen. Further, BCP regimen led to less disease progression as compared to CP (RR=0.22, 95% CI 0.09 to 0.53). Bevacizumab when combined with other chemotherapy also showed improved PFS and OS. Leukopenia and neutropenia were most common haematogical adverse events observed with bevaizumab. CONCLUSIONS: Bevacizumab plus chemotherapy is associated with significant improvement in OS, PFS, response rate and clinical benefit when compared to chemotherapy alone among patients with NSCLC.