{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T15:56:49Z","timestamp":1765727809303,"version":"3.46.0"},"reference-count":42,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,5,27]]},"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Bevacizumab and erlotinib inhibit different tumour growth pathways, and both exhibit beneficial effects in the treatment of non-small-cell lung cancer (NSCLC). However, the efficacy of bevacizumab in combination with erlotinib remains controversial. Therefore, we conducted a meta-analysis to compare combination treatment with bevacizumab and erlotinib to bevacizumab or erlotinib monotherapy in the treatment of NSCLC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Randomised controlled trials (RCTs) published in PubMed, Web of Science and EMBASE were systematically reviewed. The main outcome measures included overall survival (OS), progression-free survival (PFS), overall response rate (ORR) and adverse events. Results were expressed as HRs or risk ratios (RRs) with 95% CIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>5 RCTs involving a total of 1736 patients were included in this meta-analysis. The combination of bevacizumab and erlotinib significantly improved PFS (HR=0.63, 95% CI 0.53 to 0.75; p=0.000) and the ORR (RR=1.91, 95% CI 1.19 to 3.06; p=0.007) in the second-line treatment of NSCLC compared with bevacizumab or erlotinib alone. However, no significant difference in OS was observed between the combination and monotherapy groups (HR=0.96, 95% CI 0.83 to 1.11; p=0.573). A subgroup analysis has shown that the greatest PFS benefit was associated with an age of &lt;65\u2005years(HR=0.74, 95% CI 0.57 to 0.96; p=0.026), Asian\/Pacific Islander ethnicity (HR=0.23, 95% CI 0.10 to 0.54; p=0.001), Eastern Cooperative Oncology Group performance status (ECOG PS) 1 (HR=0.82, 95% CI 0.68 to 0.98; p=0.033), stage IIIB or IV disease (HR=0.68, 95% CI 0.57 to 0.82; p=0.000) and no history of smoking (HR=0.48, 95% CI 0.32 to 0.71; p=0.000). The incidence of grade 3\/4 adverse events such as rash and diarrhoea was higher in the combination group than in the monotherapy group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The addition of bevacizumab to erlotinib can significantly improve PFS and the ORR in the second-line treatment of NSCLC with an acceptable and manageable risk of rash and diarrhoea. Further well-conducted, large-scale trials are needed to validate these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-011714","type":"journal-article","created":{"date-parts":[[2016,6,30]],"date-time":"2016-06-30T23:03:47Z","timestamp":1467327827000},"page":"e011714","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Efficacy and safety of bevacizumab plus erlotinib versus bevacizumab or erlotinib alone in the treatment of non-small-cell lung cancer: a systematic review and meta-analysis"],"prefix":"10.1136","volume":"6","author":[{"given":"Shu","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Seventh People's Hospital of Shanghai University of TCM, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao-dong","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Chest Surgery, Seventh People's Hospital of Shanghai University of TCM, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hai-tao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Seventh People's Hospital of Shanghai University of TCM, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Seventh People's Hospital of Shanghai University of TCM, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Seventh People's Hospital of Shanghai University of TCM, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,6,30]]},"reference":[{"key":"2025120518163347000_6.6.e011714.1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.20107"},{"key":"2025120518163347000_6.6.e011714.2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.20073"},{"key":"2025120518163347000_6.6.e011714.3","doi-asserted-by":"publisher","DOI":"10.3322\/canjclin.55.2.74"},{"key":"2025120518163347000_6.6.e011714.4","doi-asserted-by":"publisher","DOI":"10.3816\/CLC.2006.s.005"},{"key":"2025120518163347000_6.6.e011714.5","unstructured":"Genentech. 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