Efficacy and safety of angiogenesis inhibitor in platinum-resistant ovarian cancer: meta-analysis on randomized controlled trial

ABSTRACT

Objective. Treatment options for platinum-resistant ovarian cancer (PROC) remain scarce, necessitating the exploration of novel therapeutic approaches, such as angiogenesis inhibitors. This study aimed to assess the effectiveness and safety of combining angiogenesis inhibitors with chemotherapy in patients diagnosed with PROC.

Materials and Methods. Systematic review and meta-analysis conducted based on PRISMA guidelines. Randomized trials comparing angiogenesis inhibitors against chemotherapy alone as treatment of PROC were identified from several electronic databases including PubMed, Cochrane, and Science Direct up to November 2023. The data were combined across trials and assessed using RevMan. The efficacy determined from progression-free survival (PFS) and overall survival (OS), and the safety assessment calculated based on the odd ratios of the adverse events (AE).

Results. Seven trials with 1,085 patients were included. Angiogenesis inhibitors significantly improved OS (HR = 0.70, 95% CI [0.58, 0.84]) and PFS (HR = 0.50, 95% CI [0.43, 0.57]). Among 15 grade ≥3 AEs analyzed, several were significantly increased with angiogenesis inhibitors, including hand-foot syndrome (OR = 3.13, 95% CI [1.40, 6.98]), hypertension (OR = 8.15, 95% CI [3.67, 18.09]), leukopenia (OR = 1.60, 95% CI [1.00, 2.57]), neutropenia (OR = 1.42, 95% CI [1.06, 1.91]), proteinuria (OR = 6.48, 95% CI [1.15, 36.62]), sensory neuropathy (OR = 3.12, 95% CI [1.51, 6.47]), and vomiting (OR = 0.36, 95% CI [0.13, 1.00]).

Conclusions. Angiogenesis inhibitors combined with chemotherapy significantly improved survival in PROC but were associated with higher rates of specific toxicities. These findings support their clinical value with attention to adverse event profiles.