The Efficacy And Safety Of Bevacizumab In Non-small Cell Lung Cancer With Brain Metastases:a Meta-analysis

Objective: To evaluate the efficacy and safety of bevacizumab in the treatment of brain metastasis from non-small cell lung cancer.Method: To determine the research object,to establish the selection criteria,to follow the principle of PICOS retrieval,to use the English database of Pubmed,Embase,Cochrane Library,the Chinese Biomedical Literature Database(CBM disc),the cnki database,the Vip database,the Wanfang database,and other Chinese databases,etc.Retrieval of literature on the treatment of brain metastases from non-small cell lung cancer by bevacizumab.The literature was managed by endnote x7 software,the titles and abstracts were selected preliminarily,and the full text was screened again.Get the documents that meet the selection criteria and use the NICE recommendation Literature quality evaluation quality evaluation criteria,use 6 months and PFS rate,12 months OS rate,ORR,DCR as efficacy evaluation criteria,and bevacizumab related brain bleeding events as the safety evaluation index.The Open Meta [analyst] software was used to detect the heterogeneity of each index,and the data were combined,and the data were analyzed by meta to investigate the efficacy and safety of bevacizumab in the treatment of brain metastases from non-small cell lung cancer.Results: Six articles of qualified literature were included,and five of them were of high quality through evaluation of literature quality.215 patients with brain metastases from non-small cell lung cancer received bevacizumab therapy.According to the data of 6 clinical studies,the median PFS of bevacizumab in the treatment of NSCLC brain metastasis ranged from 6.5 to 12 months(mean 8.5 months),and the median OS was between 9.6-16.5 months(mean 14.1 months).The data were merged with Open Meta [analyst] software.The heterogeneity analysis showed that there was no heterogeneity among the indicators.The PFS rate for 6 months after treatment of brain metastasis of non-small cell lung cancer was the ORR was 56.6%(95% CI,47.3–65.8%),the DCR was 93.2%(95% CI,88.5–97.9%),54.7%(95% CI,47.2–62.1%),the OS rate for 12 months was 60.2%(95% CI,52.9–67.5%),the incidence of intracerebral hemorrhage due to bevacizumab therapy was 1.0%(95% CI,-0.3–2.3%).Conclusion: Bevacizumab has a good short-term effect in the treatment of brain metastasis of non-small cell lung cancer(NSCLC)with mild side effects associated with bevacizumab and low incidence of intracerebral hemorrhage.Bevacizumab is one of the safe and effective treatment strategies for brain metastases from non-small cell lung cancer.