背景:中枢神经系统(CNS)肿瘤是不同年龄范围内最常见的恶性肿瘤之一。低度神经胶质瘤(LGG)可占儿科中枢神经系统恶性肿瘤的近30%。一线治疗后进展或复发在这些患者中很常见。因此,需要更多的治疗。贝伐单抗作为抗VEGF抗体最近受到关注,尤其是在复发或复发环境中使用。本文旨在研究贝伐单抗治疗复发性LGG患者的安全性和有效性。
方法:本研究按照系统评价和Meta分析的优选报告项目进行。PubMed,Scopus,WebofScience,和Embase在2023年8月24日之前使用相关关键术语进行全面检索,以检索调查贝伐单抗在复发性LGG患者中的临床结局的研究.所有统计分析均由STATAv.17进行。
结果:共收集了1306篇论文,其中13项纳入荟萃分析.根据RANO量表,客观缓解率的治疗合并发生率为70%(95%CI=43-98%),部分反应为26%(95%CI=58-96%),轻微反应为21%(95%CI=15-28%),完全缓解为14%(95%CI=3-24%),48%(95%CI=37-59%)为稳定的疾病,进行性疾病为8%(95%CI=4-11%)。此外,根据治疗后的渐进生存,6个月PFS为4%(95%CI=-1%至9%),2年PFS为41%(95%CI=32-50%),3年PFS为29%(95%CI=22-35%)。
结论:根据RANO量表和PFS,临床医生应该意识到,贝伐单抗可能是治疗复发性LGG的有利替代疗法.此外,贝伐单抗在复发性LGG中表现出最小的毒性和高耐受性。
BACKGROUND: Central nervous system (CNS) tumors are among the most common malignancies in various age ranges. Low-grade glioma (LGG) can account for nearly 30% of pediatric CNS malignancies. Progression or recurrence after the first-line treatments is common among these patients. Therefore, more treatments are required. Bevacizumab as an anti-VEGF antibody has come into the spotlight recently and is especially used in relapse or recurrence settings. This review aims to study the safety and efficacy of bevacizumab for patients with recurrent LGG.
METHODS: This study was conducted according to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses. PubMed, Scopus, Web of Science, and Embase were comprehensively searched using the relevant key terms until 24th August 2023 to retrieve the studies that investigated clinical outcomes of bevacizumab in patients with recurrent LGG. All statistical analysis was performed by STATA v.17.
RESULTS: A total of 1306 papers were gathered, out of which 13 were incorporated in the meta-analysis. The pooled incidence rate of treatment according to the RANO scale was 70% (95% CI = 43-98%) for objective response rate, 26% (95% CI = 58-96%) for partial response, 21% (95% CI = 15-28%) for minor response, 14% (95% CI = 3-24%) for complete response, 48% (95% CI = 37-59%) for stable disease, and 8% (95% CI = 4-11%) for progressive disease. Furthermore, according to progressive survival after treatment, it was 4% (95% CI = -1 to 9%) for 6-month PFS, 41% (95% CI = 32-50%) for 2-year PFS, and 29% (95% CI = 22-35%) for 3-year PFS.
CONCLUSIONS: According to the RANO scale and PFS, clinicians should be aware that Bevacizumab could be a favorable alternative therapy for recurrent LGG. Furthermore, bevacizumab exhibits minimal toxicity and high tolerability in recurrent LGG.