Objective. Bevacizumab was currently available for nonsquamous non-small-cell lung cancer (NSqNSCLC) patients and has been studied in several randomized controlled trials (RCTs) for treatment of these patients. This meta-analysis summarizes the most up-to-date evidences regarding the effects and adverse reactions of bevacizumab in the treatment of NSqNSCLC patients. Methods. The authors searched for RCTs from electronic database including PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials. Experimental arm was defined as the bevacizumab-containing group and the control arm as the bevacizumab-free group. Data of objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and adverse reactions were synthetically extracted. A protocol for this meta-analysis has been registered on PROSPERO (http://www.crd.york.ac.uk/prospero). Results. Ten RCTs that involved a total of 3134 patients were included. The experimental group was associated with significant superior ORR (RR 1.63, 95% CI 1.24 to 2.14, ), OS (HR 0.90, 95% CI 0.82 to 0.99, ), and prolonged PFS (HR 0.68, 95% CI 0.62 to 0.74, ) compared to the control. No significant difference was observed regarding DCR (RR 1.13, 95% CI 0.99 to 1.30, ). The experimental group showed higher rate of hypertension (RR 6.91, 95% CI 4.62 to 10.35, ) and hemorrhagic events (RR 3.07, 95% CI 1.78 to 5.30, ) than the control group. The experimental group showed lower rate of anemia (RR 0.72, 95% CI 0.55 to 0.96, ) than the control group. No significant difference was observed regarding treatment-related adverse event grade 3-5 (TRAE3-5) (RR 1.23, 95% CI 0.99 to 1.53, ), thrombocytopenia (RR 1.11, 95% CI 0.92 to 1.33, ), and neutropenia (RR 1.11, 95% CI 0.88 to 1.40, ). Conclusion. This meta-analysis showed that bevacizumab could increase ORR, OS, and prolonged PFS for treatment of NSqNSCLC patients. However, no significant improvement in DCR was observed and bevacizumab could increase the rate of hypertension and hemorrhagic events. Bevacizumab was an acceptable option for NSqNSCLC patients. This trial is registered with PROSPERO registration number: CRD42021226790.

中文翻译：

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贝伐单抗治疗非鳞状非小细胞肺癌的安全性和有效性：随机对照试验的荟萃分析

目标。贝伐单抗目前可用于非鳞状非小细胞肺癌 (NSqNSCLC) 患者，并且已在几项随机对照试验 (RCT) 中研究了这些患者的治疗方法。本荟萃分析总结了贝伐单抗在治疗 NSqNSCLC 患者中的作用和不良反应的最新证据。方法. 作者从电子数据库（包括 PubMed、EMBASE 和 Cochrane Central Register of Controlled Trials）中检索了 RCT。实验组定义为含贝伐单抗组，对照组定义为不含贝伐单抗组。综合提取客观缓解率（ORR）、疾病控制率（DCR）、无进展生存期（PFS）、总生存期（OS）和不良反应数据。该荟萃分析的协议已在 PROSPERO (http://www.crd.york.ac.uk/prospero) 上注册。结果。共纳入 10 项 RCT，共涉及 3134 名患者。实验组与显着优越的 ORR 相关（RR 1.63，95% CI 1.24 至 2.14，), OS (HR 0.90, 95% CI 0.82 to 0.99,)和延长的 PFS（HR 0.68，95% CI 0.62 至 0.74，)与对照相比。DCR 没有观察到显着差异（RR 1.13，95% CI 0.99 至 1.30，）。实验组显示出较高的高血压发生率（RR 6.91，95% CI 4.62 至 10.35，)和出血事件 (RR 3.07, 95% CI 1.78 to 5.30,)比对照组。实验组显示较低的贫血率（RR 0.72，95% CI 0.55 至 0.96，)比对照组。在治疗相关的 3-5 级不良事件 (TRAE3-5) 方面没有观察到显着差异（RR 1.23，95% CI 0.99 至 1.53，),血小板减少症 (RR 1.11, 95% CI 0.92 to 1.33,),和中性粒细胞减少症 (RR 1.11, 95% CI 0.88 to 1.40,）。 结论。该荟萃分析表明，贝伐珠单抗可提高治疗 NSqNSCLC 患者的 ORR、OS 和延长 PFS。然而，没有观察到 DCR 的显着改善，贝伐单抗可能会增加高血压和出血事件的发生率。贝伐单抗是 NSqNSCLC 患者可接受的选择。本试验注册了PROSPERO 注册号：CRD42021226790。