scholarly journals A Comprehensive Systematic Review and Network Meta-analysis: The Role of anti- angiogenic agents in advanced epithelial ovarian cancer

2021 ◽  
Author(s):  
Aya El Helali ◽  
Charlene HL Wong ◽  
Horace CW Choi ◽  
Wendy WL Chan ◽  
Naomi Dickson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ovarian Cancer ◽  
High Risk ◽  
Epithelial Ovarian Cancer ◽  
Comparative Effectiveness ◽  
Meta Analysis ◽  
Clinical Role ◽  
Platinum Sensitive ◽  
Platinum Resistant ◽  
Concurrent Use

Abstract BackgroundThe efficacy of anti-angiogenic agents (AAAs) in epithelial ovarian cancer (EOC) remains unclear. Therefore, we conducted a systematic review and network meta-analysis (NMA) to synthesize evidence of their comparative effectiveness for improving overall survival (OS) among EOC patients. MethodsWe searched six databases for randomized controlled trials (RCTs) from their inception to February 2021. We performed a NMA with hazard ratios (HRs) and 95% confidence intervals (CIs) to evaluate comparative effectiveness among different AAAs in two disease settings, chemotherapy naïve, and recurrent EOC. P-score was used to provide an effectiveness hierarchy ranking. Sensitivity NMA was carried out by focusing on studies that reported high-risk disease chemotherapy-naïve, platinum-resistant, and platinum-sensitive EOC. The primary outcome was OS.FindingsWe identified 23 RCTs (n=11,560) which assessed effectiveness of eight different AAAs. NMA results showed no significant OS difference among anti-angiogenic agents in chemotherapy-naïve. In recurrent EOC, concurrent use of trebananib (10mg/kg) and chemotherapy was likely to be the best option (P-score: 0.88, NMA estimate versus chemotherapy: HR= 1.67, 95% CI: 0.94; 2.94). The sensitivity NMA indicated that bevacizumab plus chemotherapy with maintenance treatment (P-score: 0.99) and pazopanib plus chemotherapy (P-score: 0.79) had the highest probability of being the best intervention for improving OS in high-risk chemotherapy-naïve and platinum-resistant setting, respectively. InterpretationAAAs may not play a significant clinical role in chemotherapy-naïve and platinum-sensitive EOC. Conversely, the concurrent use of trebananib with chemotherapy was likely to be the best intervention in recurrent EOC.

scholarly journals Early clearance of serum HE4 and CA125 in predicting platinum sensitivity and prognosis in epithelial ovarian cancer

2020 ◽  
Author(s):  
Yan Rong ◽  
Li Li
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Clinical Data ◽  
First Line ◽  
Clinical Value ◽  
Platinum Sensitivity ◽  
Platinum Sensitive ◽  
Platinum Resistant ◽  
Line Chemotherapy ◽  
Sensitive Group

Abstract Objectives: To assess the clinical value of early clearance of HE4 and CA125 for platinum sensitivity and prognosis in patients with ovarian cancer.Method: HE4 and CA125 value including clinical data of 89 patients with ovarian cancer were collected. The clearance of HE4 and CA125 were assessed base on the platinum sensitivity, two-year PFS, PFS and OS.Results: 16 patients were classified as platinum resistant and 73 as platinum sensitive according to the response to platinum-base chemotherapy. When HE4 clearance after 3rd cycle chemotherapy or CA125 clearance after 1st cycle chemotherapy, it gave the highest AUC of 0.788, with 100% of sensitivity and 57.5% of specificity respectively between platinum resistant and platinum sensitive group. In addition, 59 patients were classified as two-year PFS group and 30 as not achieved two-year PFS group according to obtaining two-year PFS or not. It gave the highest AUC of 0.730, with 83.3% of sensitivity and 62.7% of specificity respectively when HE4 clearance after 3rd cycle chemotherapy or CA125 clearance after 1st cycle. The prolonged PFS and OS were significantly associated by the clearance of HE4 after 3rd cycle chemotherapy (p<0.0001, p<0.0001) as well as CA125 after 1st cycle chemotherapy (p<0.0001, p<0.0001).Conclusions: Our data suggested that the early clearance of HE4 and CA125 could predict platinum response and prognosis in patients with ovarian cancer. Monitoring the HE4 and CA125 during first-line chemotherapy might be helpful in predicting platinum sensitivity and risk to progress and relapse.

The Impact of Sarcopenia and Low Muscle Attenuation on Overall Survival in Epithelial Ovarian Cancer: A Systematic Review and Meta-analysis

2020 ◽  
Vol 27 (9) ◽  
pp. 3553-3564 ◽  
Author(s):  
Veronica McSharry ◽  
Amy Mullee ◽  
Lara McCann ◽  
Ailin C. Rogers ◽  
Mary McKiernan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ovarian Cancer ◽  
Overall Survival ◽  
Epithelial Ovarian Cancer ◽  
Meta Analysis ◽  
Muscle Attenuation ◽  
The Impact

Alcohol drinking and epithelial ovarian cancer risk. A systematic review and meta-analysis

2012 ◽  
Vol 125 (3) ◽  
pp. 758-763 ◽  
Author(s):  
Matteo Rota ◽  
Elena Pasquali ◽  
Lorenza Scotti ◽  
Claudio Pelucchi ◽  
Irene Tramacere ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ovarian Cancer ◽  
Cancer Risk ◽  
Epithelial Ovarian Cancer ◽  
Alcohol Drinking ◽  
Meta Analysis ◽  
Ovarian Cancer Risk

scholarly journals The prognostic role of microRNA in epithelial ovarian cancer: a systematic review of literature with an overall survival meta-analysis

Oncotarget ◽  
2020 ◽  
Vol 11 (12) ◽  
pp. 1085-1095 ◽  
Author(s):  
Patricia Ferreira ◽  
Rosimeire Aparecida Roela ◽  
Rossana Veronica Mendoza Lopez ◽  
Maria Del Pilar Estevez-Diz
Keyword(s):  
Systematic Review ◽  
Ovarian Cancer ◽  
Overall Survival ◽  
Epithelial Ovarian Cancer ◽  
Meta Analysis ◽  
Review Of Literature ◽  
Prognostic Role

scholarly journals Bevacizumab in the Management of Epithelial Ovarian Cancer

2013 ◽  
Vol 09 (02) ◽  
pp. 129
Author(s):  
Maurie Markman ◽  
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Cancer Progression ◽  
Single Agent ◽  
Strong Support ◽  
Progression Free Survival ◽  
Optimal Dose ◽  
Phase Iii ◽  
Platinum Sensitive ◽  
Platinum Resistant

Preclinical investigations have provided strong support for the hypothesis that angiogenesis is a potent driver of epithelial ovarian cancer progression. Phase II data have revealed the activity of single-agent bevacizumab in previously treated and clinically defined platinum-resistant ovarian cancer. Several reported phase III randomized trials, involving primary and both ‘platinum-sensitive’ recurrent and platinum-resistant disease, have demonstrated the addition of bevacizumab to a cytotoxic chemotherapy regimen improves progression-free survival compared with chemotherapy alone. While there continues to be considerable debate regarding the optimal dose, timing, and duration of bevacizumab administration in ovarian cancer, the existing data provide strong support for an important role for this agent in the overall management paradigm for this malignancy.

scholarly journals Preoperative CT or PET/CT to Assess Pelvic and Para-Aortic Lymph Node Status in Epithelial Ovarian Cancer? A Systematic Review and Meta-Analysis

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1748
Author(s):  
Camille Mimoun ◽  
Roman Rouzier ◽  
Jean Louis Benifla ◽  
Arnaud Fauconnier ◽  
Cyrille Huchon
Keyword(s):  
Systematic Review ◽  
Ovarian Cancer ◽  
Lymph Node ◽  
Diagnostic Accuracy ◽  
Epithelial Ovarian Cancer ◽  
Meta Analysis ◽  
Lymph Node Status ◽  
Node Status ◽  
Pet Ct ◽  
Preoperative Ct

Background: In advanced epithelial ovarian cancer (EOC), the LION trial restricted lymphadenectomy indication to patients with suspect lymph nodes before and during surgery. Preoperative imaging is used to assess lymph node status, and particularly CT and PET/CT. The aim of this systematic review and meta-analysis was to evaluate the diagnostic accuracy of preoperative CT and PET/CT to detect lymph node metastasis (LNM) in patients with EOC; Methods: Databases were searched from January 1990 to May 2019 for studies that evaluated the diagnostic accuracy of preoperative CT and PET/CT to detect LNM in patients with EOC with histology as the gold standard. Pooled diagnostic accuracy was calculated using bivariate random-effects models and hierarchical summary receiver operating curve (HSROC). This study is registered with PROSPERO number CRD42020179214; Results: A total of five studies were included in the meta-analysis: four articles concerned preoperative CT and four articles concerned preoperative PET/CT, involving 106 and 138 patients, respectively. For preoperative CT, pooled sensitivity was 0.47 95% CI [0.20–0.76], pooled specificity was 0.99 95% CI [0.75–1.00] and area under the curve (AUC) of the HSROC was 0.91 95% CI [0.88–0.93]. For preoperative PET/CT, pooled sensitivity was 0.81 95% CI [0.61–0.92], pooled specificity was 0.96 95% CI [0.91–0.99] and AUC of the HSROC was 0.97 95% CI [0.95–0.98]; Conclusions: PET/CT has a very high diagnostic accuracy, especially for specificity, to detect LNM in EOC and should be realized systematically, additionally to CT recommended to evaluate peritoneal spread, in the preoperative staging of patients with an advanced disease.

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