The efficacy and safety of vascular endothelial growth factor receptor inhibitors (VEGFRIs) for recurrent ovarian cancer: a systematic review

Background: Vascular endothelial growth factor receptor inhibitors (VEGFRIs) have been common used for recurrent ovarian cancer (ROC), but insufficient high-level evidence on verifying its efficacy and safety. This systematic review (SR) aimed to evaluate the efficacy and safety of VEGFRIs for ROC. Methods: Randomized controlled trials (RCTs) were searched under eight electronic databases from their inceptions to 30th June 2021. Outcomes were included progression-free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR), quality of life (QoL), and adverse events (AEs). We calculated pooled hazard ratio (HR) and risk ratio (RR) with 95% confidence interval (CI) by Stata 14.0 and Review Manager 5.4. This systematic review was registered under INPLASY (INPLASY202120019). Results: Totally 19 RCTs involving 2125 patients were included in this SR. It demonstrated that VEGFRIs may improve PFS and OS of ROC patients both in platinum-sensitive group and platinum-resistant group. Compared to control groups, using VEGFRIs could significantly improve ORR, DCR, and QoL of the patients with ROC. Twenty two kinds of grade 3 or higher severity AEs were compared between VEGFRIs group and control groups, 14 (63.63%) of them showed no significant difference, and eight (36.36%) showed more in VEGFRIs groups. Raising gamma-glutamyl transferase, hand-foot syndrome and hypertension were with the highest incidence. Conclusion: This SR suggests VEGFRIs may be a recommended therapy for ROC because of improving PFS, OS, the clinical response, and QoL. Thought VEGFRIs increase some drug-related AEs, all the AEs could be manageable in the clinical practice.