{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:57:37Z","timestamp":1760147857776,"version":"build-2065373602"},"reference-count":104,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T00:00:00Z","timestamp":1678320000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>(1) Background: Among new anti-angiogenesis agents being developed and ever-changing guidelines indications, the question of the benefits\/safety ratio remains unclear. (2) Methods: We performed a systematic review combined with a meta-analysis of 23 randomized controlled trials (12,081 patients), evaluating overall survival (OS), progression free survival (PFS) and toxicity (grade \u2265 3 toxic effects, type, and number of all adverse effects. (3) Results: The analysis showed improvement of pooled-PFS (HR, 0.71; 95% CI, 0.64\u20130.78; I2 = 77%; p &lt; 0.00001) in first-line (HR, 0.85; 95% CI, 0.78\u20130.93; p = 0.0003) or recurrent cancer (HR, 0.62; 95% CI, 0.56\u20130.70; p &lt; 0.00001) and regardless of the type of anti-angiogenesis drug used (Vascular endothelial growth factor (VEGF) inhibitors, VEGF-receptors (VEGF-R) inhibitors or angiopoietin inhibitors). Improved OS was also observed (HR, 0.95; 95% CI, 0.90\u20130.99; p = 0.03). OS benefits were only observed in recurrent neoplasms, both platinum-sensitive and platinum-resistant neoplasms. Grade \u2265 3 adverse effects were increased across all trials. Anti-angiogenetic therapy increased the risk of hypertension, infection, thromboembolic\/hemorrhagic events, and gastro-intestinal perforations but not the risk of wound-related issues, anemia or posterior leukoencephalopathy syndrome. (4) Conclusions: Although angiogenesis inhibitors improve PFS, there are little-to-no OS benefits. Given the high risk of severe adverse reactions, a careful selection of patients is required for obtaining the best results possible.<\/jats:p>","DOI":"10.3390\/diagnostics13061040","type":"journal-article","created":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T01:35:37Z","timestamp":1678325737000},"page":"1040","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Analysis of Efficacy-To-Safety Ratio of Angiogenesis-Inhibitors Based Therapies in Ovarian Cancer: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"13","author":[{"given":"Laurentiu","family":"Simion","sequence":"first","affiliation":[{"name":"Department of Surgery, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology \u201cProf. Dr. Al. Trestioreanu\u201d, 022328 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vlad","family":"Rotaru","sequence":"additional","affiliation":[{"name":"Department of Surgery, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology \u201cProf. Dr. Al. Trestioreanu\u201d, 022328 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ciprian","family":"Cirimbei","sequence":"additional","affiliation":[{"name":"Department of Surgery, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology \u201cProf. Dr. Al. Trestioreanu\u201d, 022328 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela-Cristina","family":"Stefan","sequence":"additional","affiliation":[{"name":"Department of Surgery, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4293-0428","authenticated-orcid":false,"given":"Mirela","family":"Gherghe","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Department, Bucharest Institute of Oncology \u201cProf. Dr. Al. Trestioreanu\u201d, 022328 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sinziana","family":"Ionescu","sequence":"additional","affiliation":[{"name":"Department of Surgery, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology \u201cProf. Dr. Al. Trestioreanu\u201d, 022328 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bogdan Cosmin","family":"Tanase","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Department, Bucharest Institute of Oncology \u201cProf. Dr. Al. Trestioreanu\u201d, 022328 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan Cristian","family":"Luca","sequence":"additional","affiliation":[{"name":"Department of Surgery, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology \u201cProf. Dr. Al. Trestioreanu\u201d, 022328 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0414-1607","authenticated-orcid":false,"given":"Laurentia Nicoleta","family":"Gales","sequence":"additional","affiliation":[{"name":"Department of Surgery, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Medical Oncology Department, Bucharest Institute of Oncology \u201cProf. Dr. Al. Trestioreanu\u201d, 022328 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9225-8030","authenticated-orcid":false,"given":"Elena","family":"Chitoran","sequence":"additional","affiliation":[{"name":"Department of Surgery, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology \u201cProf. Dr. Al. Trestioreanu\u201d, 022328 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,9]]},"reference":[{"key":"ref_1","unstructured":"(2023, January 02). Ovary-Fact-Sheet. 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