Cochrane · systematic review · CD007930
Angiogenesis inhibitors for the treatment of epithelial ovarian cancer
Gaitskell, K, Rogozińska, E, Platt, S, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
Gynaecological, Neuro-oncology and Orphan CancerAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
48
current version
GRADE rated
34
No studies
14
Included studies
NR
No studies 14 · 29.2%Ungraded 0 · 0%Very low 2 · 4.2%Low 13 · 27.1%Moderate 15 · 31.3%High 4 · 8.3%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Chemotherapy with bevacizumab followed by maintenance bevacizumab compared to chemotherapy alone in newly‐diagnosed EOC
Population: newly‐diagnosed EOC
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival (OS) Chemotherapy with bevacizumab followed by maintenance bevacizumab vs chemotherapy alone | HR 0.97 [0.88, 1.07] | 2 studies · 2776 participants | Moderate Downgraded: imprecision |
Progression‐free survival (PFS) Chemotherapy with bevacizumab followed by maintenance bevacizumab vs chemotherapy alone | HR 0.82 [0.64, 1.05] | 2 studies · 2746 participants | Very low Downgraded: imprecision, inconsistency |
Quality of life (QoL) Chemotherapy with bevacizumab followed by maintenance bevacizumab vs chemotherapy alone | no estimate extracted | 1 study · 890 participants | High |
Any adverse event grade ≥ 3 Chemotherapy with bevacizumab followed by maintenance bevacizumab vs chemotherapy alone | RR 1.16 [1.07, 1.26] | 1 study · 1485 participants | Moderate Downgraded: imprecision |
Hypertension (grade ≥ 2) Chemotherapy with bevacizumab followed by maintenance bevacizumab vs chemotherapy alone | RR 4.27 [3.25, 5.6] | 2 studies · 2707 participants | Low Downgraded: inconsistency |
Bowel fistula / perforation (grade ≥ 3) Chemotherapy with bevacizumab followed by maintenance bevacizumab vs chemotherapy alone | no estimate extracted | NR | No studies |
Chemotherapy with TKI followed by TKI maintenance compared to chemotherapy alone in newly‐diagnosed EOC
Population: newly‐diagnosed EOC
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival (OS) Chemotherapy with TKI followed by TKI maintenance vs chemotherapy alone | HR 0.99 [0.84, 1.17] | 2 studies · 1451 participants | Moderate Downgraded: imprecision |
Progression‐free survival (PSF) Chemotherapy with TKI followed by TKI maintenance vs chemotherapy alone | HR 0.88 [0.77, 1] | 2 studies · 1451 participants | Moderate Downgraded: imprecision |
Quality of life (QoL) Chemotherapy with TKI followed by TKI maintenance vs chemotherapy alone | no estimate extracted | 1 study · 1340 participants | Moderate Downgraded: imprecision |
Any adverse event grade ≥ 3 Chemotherapy with TKI followed by TKI maintenance vs chemotherapy alone | RR 1.31 [1.11, 1.55] | 1 study · 188 participants | Moderate Downgraded: imprecision |
Hypertension grade ≥ 3 Chemotherapy with TKI followed by TKI maintenance vs chemotherapy alone | RR 6.49 [2.02, 20.87] | 1 study · 1352 participants | Low Downgraded: imprecision |
Bowel fistula / perforation (grade ≥ 3) Chemotherapy with TKI followed by TKI maintenance vs chemotherapy alone | no estimate extracted | NR | No studies |
Chemotherapy with TKI (peptide‐Fc fusion protein) followed by TKI maintenance compared to chemotherapy alone in newly‐diagnosed EOC
Population: newly‐diagnosed EOC
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival (OS) Chemotherapy with TKI (peptide‐Fc fusion protein) followed by TKI maintenance vs chemotherapy alone | HR 0.99 [0.79, 1.25] | 1 study · 1015 participants | Moderate Downgraded: imprecision |
Progression‐free survival (PSF) Chemotherapy with TKI (peptide‐Fc fusion protein) followed by TKI maintenance vs chemotherapy alone | HR 0.93 [0.79, 1.09] | 1 study · 1015 participants | Moderate Downgraded: imprecision |
Quality of life (QoL) Chemotherapy with TKI (peptide‐Fc fusion protein) followed by TKI maintenance vs chemotherapy alone | no estimate extracted | NR | No studies |
Any adverse event grade ≥ 3 Chemotherapy with TKI (peptide‐Fc fusion protein) followed by TKI maintenance vs chemotherapy alone | no estimate extracted | 1 study · 1011 participants | Moderate Downgraded: imprecision |
Hypertension grade ≥ 3 Chemotherapy with TKI (peptide‐Fc fusion protein) followed by TKI maintenance vs chemotherapy alone | no estimate extracted | NR | No studies |
Bowel fistula / perforation (grade ≥ 3) Chemotherapy with TKI (peptide‐Fc fusion protein) followed by TKI maintenance vs chemotherapy alone | no estimate extracted | NR | No studies |
Chemotherapy with bevacizumab followed by bevacizumab maintenance compared to chemotherapy alone in recurrent platinum‐sensitive EOC
Population: recurrent platinum‐sensitive EOC
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival (OS) Chemotherapy with bevacizumab followed by bevacizumab maintenance vs chemotherapy alone | HR 0.9 [0.79, 1.02] | 3 studies · 1564 participants | Moderate Downgraded: imprecision |
Progression‐free survival (PFS) Chemotherapy with bevacizumab followed by bevacizumab maintenance vs chemotherapy alone | HR 0.56 [0.5, 0.63] | 3 studies · 1564 participants | Moderate |
Quality of life (QoL) Chemotherapy with bevacizumab followed by bevacizumab maintenance vs chemotherapy alone | no estimate extracted | 1 study · 486 participants | Low Downgraded: imprecision |
Any adverse event (grade ≥3) Chemotherapy with bevacizumab followed by bevacizumab maintenance vs chemotherapy alone | RR 1.11 [1.07, 1.16] | 3 studies · 1538 participants | High |
Hypertension (grade ≥ 2) Chemotherapy with bevacizumab followed by bevacizumab maintenance vs chemotherapy alone | no estimate extracted | NR | No studies |
Bowel fistula / perforation (grade ≥ 3) Chemotherapy with bevacizumab followed by bevacizumab maintenance vs chemotherapy alone | no estimate extracted | NR | No studies |
Chemotherapy with TKI followed by TKI maintenance compared to chemotherapy alone in recurrent platinum‐sensitive EOC
Population: recurrent platinum‐sensitive EOC
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival (OS) Chemotherapy with TKI followed by TKI maintenance vs chemotherapy alone | HR 0.86 [0.67, 1.11] | 1 study · 282 participants | Low Downgraded: imprecision |
Progression‐free survival (PFS) Chemotherapy with TKI followed by TKI maintenance vs chemotherapy alone | HR 0.56 [0.44, 0.72] | 1 study · 282 participants | Moderate |
Quality of life (QoL) Chemotherapy with TKI followed by TKI maintenance vs chemotherapy alone | no estimate extracted | 1 study · 146 participants | Low Downgraded: imprecision |
Any adverse events (grade ≥ 3) Chemotherapy with TKI followed by TKI maintenance vs chemotherapy alone | no estimate extracted | NR | No studies |
Hypertension (grade ≥ 2) Chemotherapy with TKI followed by TKI maintenance vs chemotherapy alone | no estimate extracted | NR | No studies |
Bowel fistula/perforation (grade ≥ 3) Chemotherapy with TKI followed by TKI maintenance vs chemotherapy alone | no estimate extracted | NR | No studies |
Chemotherapy with bevacizumab compared to chemotherapy alone in recurrent platinum‐resistant EOC
Population: recurrent platinum‐resistant EOC
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival (OS) Chemotherapy with bevacizumab vs chemotherapy alone | HR 0.73 [0.61, 0.86] | 5 studies · 778 participants | High |
Progression‐free survival (PFS) Chemotherapy with bevacizumab vs chemotherapy alone | HR 0.49 [0.42, 0.58] | 5 studies · 778 participants | Moderate Downgraded: risk of bias |
Quality of life Chemotherapy with bevacizumab vs chemotherapy alone | no estimate extracted | NR | No studies |
Any adverse event grade ≥ 3 Chemotherapy with bevacizumab vs chemotherapy alone | RR 1.68 [0.76, 3.69] | 1 study · 101 participants | Low Downgraded: risk of bias, imprecision |
Hypertension (grade ≥ 2) Chemotherapy with bevacizumab vs chemotherapy alone | RR 3.11 [1.83, 5.27] | 2 studies · 436 participants | Low Downgraded: risk of bias, imprecision |
Bowel fistula / perforation (grade ≥ 2) Chemotherapy with bevacizumab vs chemotherapy alone | RR 6.89 [0.86, 55.09] | 2 studies · 436 participants | Low Downgraded: risk of bias, imprecision |
Chemotherapy with TKI compared to chemotherapy alone in recurrent platinum‐resistant EOC
Population: recurrent platinum‐resistant EOC
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival (OS) Chemotherapy with TKI vs chemotherapy alone | HR 0.85 [0.68, 1.08] | 8 studies · 940 participants | Moderate Downgraded: imprecision |
Progression‐free survival (PFS) Chemotherapy with TKI vs chemotherapy alone | HR 0.7 [0.55, 0.89] | 8 studies · 940 participants | Low Downgraded: risk of bias, inconsistency |
Quality of life (QoL) Chemotherapy with TKI vs chemotherapy alone | no estimate extracted | 3 studies · 164 participants | Low Downgraded: risk of bias, imprecision |
Any adverse events (grade ≥3) Chemotherapy with TKI vs chemotherapy alone | RR 1.23 [1.02, 1.49] | 4 studies · 548 participants | Low Downgraded: risk of bias, inconsistency |
Hypertension (grade ≥ 2)Â Chemotherapy with TKI vs chemotherapy alone | no estimate extracted | NR | No studies |
Bowel fistula / perforation (grade ≥ 3) Chemotherapy with TKI vs chemotherapy alone | RR 2.74 [0.77, 9.75] | 5 studies · 557 participants | Very low Downgraded: risk of bias, imprecision |
Chemotherapy with TKI (peptide‐Fc fusion protein) compared to chemotherapy alone in recurrent EOC
Population: recurrent EOC
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival (OS) Chemotherapy with TKI (peptide‐Fc fusion protein) vs chemotherapy alone | HR 0.92 [0.8, 1.06] | 3 studies · 1250 participants | Moderate Downgraded: imprecision |
Progression‐free survival (PFS) Chemotherapy with TKI (peptide‐Fc fusion protein) vs chemotherapy alone | HR 0.73 [0.65, 0.82] | 3 studies · 1250 participants | High |
Quality of life (QoL) Chemotherapy with TKI (peptide‐Fc fusion protein) vs chemotherapy alone | no estimate extracted | 1 study · 315 participants | Low Downgraded: imprecision |
Any adverse events (grade ≥3)Â Chemotherapy with TKI (peptide‐Fc fusion protein) vs chemotherapy alone | no estimate extracted | NR | No studies |
Hypertension (grade ≥ 2)Â Chemotherapy with TKI (peptide‐Fc fusion protein) vs chemotherapy alone | no estimate extracted | NR | No studies |
Bowel fistula / perforation (grade ≥ 3) Chemotherapy with TKI (peptide‐Fc fusion protein) vs chemotherapy alone | RR 0.35 [0.01, 8.3] | 1 study · 108 participants | Low Downgraded: imprecision |