Molecular targeted therapy in combination with chemotherapy for the treatment of platinum-resistant/refractory ovarian cancer (PROC): a systematic review and network meta-analysis.
Tianshu Ying, Shaolong E, Huanchun Ying
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In 30 seconds
This Bayesian network meta-analysis compared molecular targeted agents combined with chemotherapy against chemotherapy alone for platinum-resistant or refractory ovarian cancer (PROC). It included 22 randomised controlled trials with 3,408 participants and assessed overall survival, progression-free survival and adverse events. Combinations involving bevacizumab, sorafenib or adavosertib significantly improved survival outcomes versus chemotherapy alone; for sorafenib, the reported overall-survival hazard ratio was 0.65 (95% CI: 0.45-0.93), and for adavosertib it was 0.56 (95% CI: 0.35-0.90). The authors identified paclitaxel plus bevacizumab as the best balance of efficacy and safety.
Key findings
- Across included trials, chemotherapy combinations with bevacizumab had hazard ratios of 0.52-0.65 and significantly improved overall and progression-free survival versus chemotherapy alone.
- Sorafenib combinations improved survival outcomes; the reported hazard ratio was 0.65 (95% CI: 0.45-0.93).
- Adavosertib combinations improved survival outcomes, but adavosertib plus gemcitabine increased grade 3-4 adverse events (RR = 1.8, 95% CI: 1.3-2.7).
- The analysis identified paclitaxel plus bevacizumab as the optimal balance of efficacy and safety; topotecan plus sorafenib was proposed as an alternative when anti-angiogenic therapy is unsuitable.
Why it matters
PROC has limited treatment options, and this synthesis suggests that adding targeted agents to chemotherapy can improve survival outcomes compared with chemotherapy alone. The findings also highlight that efficacy and toxicity differ by regimen: the reported increase in severe adverse events with adavosertib plus gemcitabine underscores the importance of weighing harms alongside potential benefit.
What to keep in mind
The findings are based on a network meta-analysis of trials rather than a single direct comparison of every regimen; the abstract does not report further limitations.