Atezolizumab plus bevacizumab in combination with platinum based chemotherapy for ovarian cancer: A systematic review and meta-analysis of randomized control trials.

Abstract

e17558 Background: Ovarian cancer continues to be a major factor in cancer related morbidity and mortality worldwide. Recent developments in treatment have investigated the effectiveness of combining immune checkpoint inhibitors, like atezolizumab with bevacizumab in combination with platinum-based chemotherapy. This study evaluates the clinical effectiveness and safety of this combination in comparison to conventional therapies. Methods: PubMed, Embase, Scopus, and Cochrane CENTRAL databases were queried to retrieve studies evaluating the efficacy and safety of atezolizumab in combination with bevacizumab and platinum-based chemotherapy for ovarian cancer. Odds ratios (OR) with 95% CI were pooled using the random-effects model, and a p-value of <0.05 was considered statistically significant. Results: Four studies involving a total of 3,641 patients were analyzed. The use of atezolizumab with bevacizumab in combination with platinum-based therapy for ovarian cancer showed a significant advantage in progression-free survival (PFS) for the treatment group (mean difference 1.61; 95% CI: 0.61–2.61; p = 0.002), though notable heterogeneity limits generalizability. However overall survival (OS) did not reveal a significant difference (mean difference 2.97; 95% CI: -0.71–6.66; p = 0.11). The risk of developing autoimmune disorders was significantly greater in the treatment group (RR 1.62; 95% CI: 1.10–2.38; p = 0.02, I² = 37%). There were no significant differences found for treatment-related adverse events (RR 1.00; 95% CI: 0.98–1.02; p = 0.78) or for any grade of adverse events (RR 1.03; 95% CI: 0.99–1.08; p = 0.15). Conclusions: The atezolizumab therapy showed a marked enhancement in progression-free survival however, the considerable variability among the studies makes it challenging to interpret and apply these results broadly. The lack of significant difference in overall survival suggests that further investigations are needed to clarify long-term benefits. While the treatment was linked to an increased risk of autoimmune disorder occurrences, its safety profile concerning treatment-related side effects remains uncertain. Large scale robust trials are needed to be undertaken to determine the most optimal management.