Risk profile of bevacizumab in patients with non-small cell lung cancer: A meta-analysis of randomized controlled trials

Background. Severe adverse events (AEs) have been reported in cancer patients treated with bevacizumab. Currently, safety of bevacizumab in patients with non-small cell lung cancer (NSCLC) is not clear. We conducted a meta-analysis to evaluate the risk profile of bevacizumab in NSCLC patients. Methods. Relevant trials were identified by searching databases and conference proceedings. Data on treatment-related deaths and grade 3 or 4 AEs were extracted and pooled to calculate relative risks (RRs) with 95% confidence interval (CI) for bevacizumab compared with chemotherapy alone. Results. A total of 2210 patients were included in the analysis. Compared with chemotherapy alone, high-dosage (15 mg/kg) bevacizumab was associated with an increased risk of treatment-related deaths (RR = 2.04, 95% CI = 1.18-3.52), but not for low-dosage (7.5 mg/kg) group (RR = 1.20, 95% CI = 0.60-2.41). In addition, treatment with bevacizumab was associated with several grade 3 or 4 AEs in patients with NSCLC, especially in high-dosage bevacizumab group. Conclusion. The use of the bevacizumab increases the risk of treatment-related deaths and several grade 3 or 4 AEs in patient with NSCLC. The risk may be dose-dependent. Close monitoring and adequate management are recommended to decrease severe AEs.