Jinli Wei, * Yulin Luo, * Deyuan Fu
Department of Thyroid and Chest Surgery, Northern Jiangsu People's Hospital, Yangzhou 225001, Jiangsu, People's Republic of China
* These authors contributed just to this work
Purpose: To better clarify the effect of neoadjuvant bevacizumab plus chemotherapy (BEV + CT) vs chemotherapy (CT) alone in the treatment of HER2 negative nonmetastatic breast cancer.
methods: PubMed, Embase, Web of Science and Cochrane Library databases were searched for relevant articles published from January 1, 2000 to July 31, 2018. Review Manager software version 5.3 was used to perform this meta-analysis.
results: Six randomized controlled trials matched the selection criteria, giving a total of 4,354 patients with early results and 3,777 patients with delayed results. Pool Pathological Full Response (pCR) and 5-year disease-free survival (DFS) were higher for the neoadjuvant BEV + CT group (OR = 1.37 [1.19, 1.58]; P<0.001 and HR = 0.84 [0.72, 0.98]; P= 0.020), but 5 years of survival (OS) showed no significant difference (HR = 0.79 [0.55, 1.11]; P= 0.180). Subgroup analysis showed that the pCR rate was significantly higher in both patients with hormone receptor (HR) positive breast cancer (OR = 1.30 [1.01, 1.66]; P= 0.040) and those with HR negative breast cancer (OR = 1.52 [1.25, 1.83]; P<0.001) in the BEV + CT group.
conclusion: Compared with CT alone, neoadjuvant BEV + CT significantly improved the 5-year DFS rate for HER2 negative breast cancer patients, but showed no benefit in terms of 5-year OS rate.
Keyword: bevacizumab, neoadjuvant chemotherapy, breast cancer, HER2 negative, randomized controlled trial
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