Efficacy And Safety Of Angiogenesis Inhibitors In The Treatment Of Malignant Pleural Mesothelioma:A Meta-analysis

Objective:To systematically evaluate the efficacy and safety of angiogenesis inhibitors in the treatment of malignant pleural mesothelioma(MPM).Methods:Randomed controlled trials(RCTs)of angiogenesis inhibitors for MPM were collected through four Chinese and English databases by computer including Pubmed,The Cochrane Library,Embase and CNKI,and literature published by self-built databases until December 10,2020.After the extraction of the study data and the quality assessment of the included RCTs,Rev Man 5.3 software was used for statistical processing.Results:A total of 1471 patients were included in 5 English RCTs.The intervention group received angiogenesis inhibitors plus chemotherapy,while the control group received placebo plus chemotherapy or chemotherapy alone.Meta-analysis results showed that there was no statistically significant difference in overall survival(OS)between the angiogenesis inhibitors experimental group and the control group(HR=0.88,95%CI0.77-1.00,p=0.05),while there was great difference in PFS(HR=0.76,95%CI 0.59-0.98,p=0.04).Subgroup analysis revealed that OS and PFS in the angiogenesis inhibitors experimental group with previous radiotherapy or surgical history were higher than those in the control group(HR=0.79,95%CI 0.66-0.94,p=0.01;HR=0.61,95%CI 0.52-0.73,p<0.00001).In terms of safety,the rate of grade 3-5 adverse reactions in the angiogenesis inhibitors group was 1.19 times that of the control group,and the difference between the two groups was statistically significant(RR=1.19,95%CI 1.10-1.29,p<0.00001).Conclusion:1.Total analysis showed that angiogenesis inhibitors could prolong PFS in MPM patients,and OS was prolonged,but there was no statistically significant difference(P=0.05);2.Subgroup analysis showed that the angiogenesis inhibitors experimental group with previous radiotherapy or surgery had prolonged OS and PFS,revealing that the angiogenesis inhibitors had a positive effect on MPM patients with previous radiotherapy or surgery;3.The total analysis found that the incidence of adverse reactions in the experimental group was slightly higher than that in the control group,which was about 1.19 times,indicating that the toxic and side effects of angiogenesis inhibitors were within the acceptable range.