贝伐单抗联合化疗在PARPi后复发卵巢癌中优于单纯化疗的多中心倾向评分匹配分析证据
Bevacizumab combined with chemotherapy could be superior to chemotherapy alone in relapsed ovarian cancer after PARPi: evidence from a multi-center propensity score-matched analysis
影响因子:3.70000
分区:医学2区 / 妇产科学3区 肿瘤学3区
发表日期:2025 May
作者:
Lin Zhong, Haixia Wang, Cuirong Lei, Dongling Zou
摘要
本研究为一项回顾性、多中心倾向评分匹配（PMS）分析，旨在探讨贝伐单抗联合化疗治疗在先前接受多聚腺苷二磷核糖聚合酶（PARPi）治疗后复发的上皮性卵巢癌（EOC）患者的疗效与安全性。共纳入来自4个医疗中心的250例PARPi后复发、接受化疗（含或不含贝伐单抗）的卵巢癌患者，采用Kaplan-Meier分析和Cox回归比较无进展生存期（PFS）。多变量分析显示，加入贝伐单抗显著延长PFS（HR=0.49；95% CI=0.34-0.72；p<0.001）。在PMS分析后，A组（贝伐单抗联合化疗）和B组（单纯化疗）各55例患者被纳入。两组间PFS差异具有统计学意义（HR=0.62；95% CI=0.40-0.97；p=0.036），提示贝伐单抗联合化疗方案具有优越的临床获益。A组中位PFS为11个月，B组为9个月。无RCRS（HR=0.50；95% CI=0.30-0.82）及铂耐药亚组（HR=0.31；95% CI=0.14-0.68）中PFS差异显著。A组中3-4级不良反应更常见，且仅在A组报告了严重高血压和肠穿孔的病例。在PARPi后复发的EOC患者中，化疗联合贝伐单抗方案与更佳PFS相关。
Abstract
A retrospective, multi-center propensity score-matched (PMS) analysis was conducted to investigate the efficacy and safety of the treatment strategy that combines bevacizumab and chemotherapy for patients with relapsed epithelial ovarian cancer (EOC) who previously received poly ADP-ribose polymerase inhibitors (PARPis).A total of 250 ovarian cancer (OC) patients relapsed after PARPi received chemotherapy with or without bevacizumab at 4 medical centers were enrolled in the study. For both treatments, Kaplan-Meier analysis and Cox regression were used to compare PFS.In the multivariable analysis of 250 patients, the incorporation of bevacizumab into chemotherapy demonstrated a significant enhancement in PFS (hazard ratio [HR]=0.49; 95% confidence interval [CI]=0.34-0.72; p<0.001). Fifty-five patients were enrolled in Group A (bevacizumab combined with chemotherapy) and 55 were enrolled in Group B (chemotherapy alone regime) after PSM analysis. A statistically significant difference in PFS was observed between the 2 regimens (HR=0.62; 95% CI=0.40-0.97; p=0.036), suggesting that the bevacizumab combined with chemotherapy regimen confers superior clinical benefits. The median PFS was 11 months in Group A and 9 months in Group B. A significant variation was noted in PFS between patients without RCRS (HR=0.50; 95% CI=0.30-0.82) and the platinum-resistant subgroup (HR=0.31; 95% CI=0.14-0.68). Adverse effects of Grade 3-4 were more prevalent in Group A than in Group B. Additionally, instances of severe hypertension and bowel perforation were reported solely within Group A.In patients diagnosed with EOC relapsed after PARPi, the regime of chemotherapy combined with bevacizumab is associated with better PFS.