Adverse events risk associated with angiogenesis inhibitors addition to therapy in ovarian cancer: a meta-analysis of randomized controlled trials.

Objective: Inhibition of angiogenesis has been regarded as an attractive treatment strategy for advanced or recurrent ovarian cancer. We conduct this meta-analysis to investigate the risk of adverse events of special interest related to angiogenesis inhibitors (AIs) in ovarian cancer.

Patients And Methods: Databases from PubMed, Web of Science and Cochrane library up to December 2015 were searched to identify relevant studies. Eligible studies included prospective randomized controlled phase II/III clinical trials evaluating therapy with or without AIs for ovarian cancer. Summary relative risk (RR) and 95% confidence intervals (CIs) were calculated using random-effects or fixed-effects according to the heterogeneity among included trials.

Results: A total of 7,761 patients from ten clinical trials were included in the meta-analysis. Pooled RR showed that the use of AIs was associated with a statistically increased risk in four of the adverse outcomes studied: arterial thromboembolic events (RR = 2.0), gastrointestinal (GI) perforation (RR = 3.86), proteinuria (RR = 2.44), and hypertension (RR = 5.39). No statistically significant differences were found for hemorrhagic events (p = 0.07), venous thromboembolic events (p = 0.13), or fatal adverse events (p = 0.26).

Conclusions: The addition of AIs to therapy in ovarian cancer did significantly increase the risk of arterial thromboembolic events, GI perforation, proteinuria and hypertension, but not for venous thromboembolic events, hemorrhagic events, or fatal adverse events.