Predictive value of vascular endothelial growth factor A (VEGF-A) for bevacizumab-based treatments across advanced cancers: a meta-analysis based on eight phase III randomized control trials involving 4,523 patients

Background

Bevacizumab, a monoclonal antibody against vascular endothelial growth factor (VEGF), has been shown to be beneficial for patients with advanced cancer in phase III randomized control trials which had associated biomarker analyses. We aim to evaluate the predictive value of circulating VEGF-A on patient survival in these studies.

Methods

PubMed was searched for eligible trials from the date of inception to 31st December, 2015. Based on the median circulating level of VEGF-A in each trial, we conducted a meta-analysis with random-effect model to estimate the treatment effects between bevacizumab-based treatments and treatments without bevacizumab on progression-free survival (PFS) and overall survival (OS). Interaction test was used to examine the predictive value.

Results

Eight studies were included, involving 4,523 patients analyzed with VEGF-A level. Patients following bevacizumab-based treatments had significantly prolonged PFS regardless of VEGF-A level (high:HR = 0.70 [95 % CI 0.63-0.77], P 

Conclusions

There is still insufficient evidence to support the use of VEGF-A as a predictive biomarker for bevacizumab-based treatment in advanced cancers.

Clinical trial identification

Legal entity responsible for the study

N/A

Funding

The First Affiliated Hospital of Guangzhou Medical University

Disclosure

All authors have declared no conflicts of interest.