# Combination of pemetrexed with bevacizumab for non-small-cell lung cancer: a meta-analysis study

## TL;DR

Adding pemetrexed to bevacizumab improves survival and treatment outcomes in non-small-cell lung cancer, but increases severe side effects.

## Contribution

This meta-analysis demonstrates that combining pemetrexed with bevacizumab improves survival metrics in NSCLC patients.

## Key findings

- Pemetrexed addition improved overall survival with a hazard ratio of 0.87.
- Progression-free survival was significantly enhanced with a hazard ratio of 0.63.
- The combination increased grade ≥3 adverse events with an odds ratio of 2.15.

## Abstract

Combining pemetrexed with bevacizumab may have some potential in improving the efficacy in patients with non-small-cell lung cancer (NSCLC), and this meta-analysis aims to explore the impact of pemetrexed addition to bevacizumab on treatment efficacy for NSCLC.

PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched, and we included randomized controlled trials (RCTs) assessing the effect of pemetrexed addition to bevacizumab on treatment efficacy in patients with NSCLC. Overall survival and progression-free survival were included in this meta-analysis.

Four RCTs were finally included in the meta-analysis. Overall, compared with bevacizumab for NSCLC, pemetrexed addition showed significantly improved overall survival (hazard ratio [HR] = 0.87; 95% confidence interval [CI] = 0.76 to 0.99; P = 0.03), survival rate (odd ratio [OR] = 1.41; 95% CI = 1.06 to 1.86; P = 0.02), progression-free survival (HR = 0.63; 95% CI = 0.55 to 0.72; P < 0.00001) and progression-free survival rate (OR = 1.92; 95% CI = 1.38 to 2.67; P < 0.00001), but led to the increase in grade ≥ 3 adverse events (OR = 2.15; 95% CI = 1.62 to 2.84; P < 0.00001).

Pemetrexed addition may be effective to improve treatment efficacy for NSCLC compared to bevacizumab treatment.