癌患者のベバシズマブによる治療関連死亡率:メタ解析
Vishal Ranpura1, Sanjaykumar Hapani, Shenhong Wu
1Department of Medicine, Stony Brook University Cancer Center, 9447 SUNY, Stony Brook, NY 11794, USA.
JAMA
|February 3, 2011
まとめ
化学療法にベバシズマブを添加すると,がん患者の致命的な有害事象 (FAE) のリスクが増加します. このメタ解析はベバシズマブを裏付けている.
科学分野:
- 腫瘍学 腫瘍学
- 薬理学 薬理学とは
- クリニック・トライアル 臨床試験
背景:
- 致命的な有害事象 (FAE) は,ベバシズマブ (血管新生阻害剤) を化学療法と併用して投与されたがん患者で報告されています.
- ベバシズマブの治療関連死亡率に対する正確な貢献は不明である.
研究 の 目的:
- ランダム化制御試験 (RCT) のシステマティック・レビューとメタ分析を実施する.
- 癌治療におけるベバシズマブに関連したFAEの全体的なリスクを決定する.
主な方法:
- PubMed,EMBASE,Web of Scienceのデータベースを体系的に検索し,ASCOの会議要約 (1966-2010) を追加しました.
- ベバシズマブと化学療法/生物療法と化学療法/生物療法のみを比較した将来的なRCTの含有.
- 固定効果またはランダム効果モデルを使用して,概要発生率と相対リスク (RRs) の計算.
主要な成果:
- 分析には,様々な進行した固体腫瘍を対象とした16件のRCTから10,217人の患者が含まれていた.
- ベバシズマブによるFAEの総発生率は2.5% (95%CI,1.7%-3.9%) であった.
- ベバシズマブはFAEのリスクを有意に増加させた (RR=1.46,P=.01),特にタキサンやプラチナ剤 (RR=3.49) による.
- 一般的なFAEには,出血,中性不全,胃腸の穿孔が含まれていました.
結論:
- ベバシズマブは,化学療法または生物療法と併用すると,治療に関連する死亡率の増加と関連しています.
- FAEのリスクは,使用された特定の化学療法剤によって異なります.
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