Efficacy And Safety Of VEGFR-TKIs In Advanced And Recurrent Ovarian Cancer:A Meta-analysis

Objective: To systematically review the efficacy and safety of VEGFR-tyrosine kinase inhibitors(VEGFR-TKIs)in the treatment of advanced ovarian cancer,and to explore the application value of VEGFR-TKIs in advanced ovarian cancer.Methods: An electronically search was conducted in Pub Med,Em Base and Web of Science databases from inception to December 2018 to collect randomized controlled trials(RCT)about VEGFR-TKIs chemotherapy for advanced and recurrent ovarian cancer.After screening literature,extracting data,evaluating research quality and assessing the risk of bias.The meta-analysis was performed using Rev Man 5.3.5 software.Results: The meta-analysis results showed that: The progression-free survival(PFS)of patients with advanced and recurrent ovarian cancer was prolonged with VEGFR-TKIs monotherapy or combination chemotherapy compared with placebo or chemotherapy alone [HR=0.76,95% CI(0.69-0.84),P<0.00001],but the difference in overall survival(OS)of patients with advanced and recurrent ovarian cancer was not statistically significant [HR=0.91,95% CI(0.80-1.03),P=0.14].The safety of VEGFR-TKIs in the treatment of advanced and recurrent ovarian cancer is in the acceptable range,but some level 3 or level 3 above adverse reaction risk was increased,such as leukopenia [RR = 1.28,95% CI(1.03 1.58),P = 0.02),anorexia(RR = 4.74,95% CI(1.03 21.71),P = 0.05),diarrhea(RR = 4.13,95% CI(1.31 13.07),P = 0.02),hypertension [RR=8.42,95% CI(3.22-22.06),P<0.0001],fatigue [RR=2.33,95% CI(1.58-3.44),P<0.0001],rash [RR=8.14,95%CI(1.68-39.44),P=0.009] and hand-foot syndrome [RR = 27.18,95% CI(6.65 111.05),P < 0.0001].Conclusion: VEGFR-TKIs generally can prolong the PFS of the patients with advanced and recurrent ovarian cancer,but not significantly prolong the OS.The safety of VEGFR-TKIs in the treatment of recurrent ovarian cancer was at an acceptable range,and some types of level 3 or level 3 above adverse reaction risk were increased such as leukopenia,anorexia,diarrhea,hypertension,fatigue,rash,and hand-foot syndrome.