Efficacy and safety of VEGFR inhibitors for recurrent ovarian cancer: a systematic review

<b>Aim:</b> 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. <b>Methods:</b> Randomized controlled trials (RCTs) were searched under eight electronic databases. Stata 14.0 and Review Manager 5.3 were used for data analysis. Certainty of the evidence was assessed using the GRADE profiler. This systematic review (SR) was registered under INPLASY (INPLASY202120019). <b>Conclusion:</b> Totally 23 RCTs involving 2810 patients were included in this SR. Current evidence revealed that VEGFRIs had better efficacy, survival and quality of life in the treatment of ROC. Though VEGFRIs increase some drug-related adverse events (AEs), all the AEs could be manageable in the clinical practice. The expression of VEGF/VEGF receptors (VEGFRs) in ovarian cancer (OC) tissue was found to be higher than in benign or normal ovarian tissue. Therefore angiogenesis inhibitors play an essential role in OC treatment. Many anti-angiogenic agents have been developed in recent years. The role of small-molecule inhibitors of VEGFRs for recurrent OC (ROC) has demonstrated significant antitumor efficacy. These drugs include Nintedanib, Axitinib, Pazopanib, Sorafenib, Vandetanib, Sunitinib, Cediranib, Ramucirumab and Apatinib, and more are in the way. However, insufficient high-level evidence from systematic reviews (SRs) focused on VEGFRIs for ROC. Therefore, we performed an SR to investigate the efficacy and safety of VEGFRIs for patients with ROC. This SR was registered under INPLASY (INPLASY202120019). Totally 23 RCTs involving 2810 patients were included in this SR. The results indicate that VEGFRIs have better efficacy and survival in the treatment of ROC. Though VEGFRIs increase some drug-related adverse events, all the adverse events could be manageable in clinical practice. We performed an systematic reviews to investigate the efficacy and safety of VEGFR inhibitors for recurrent ovarian cancer (ROC). The results indicate that VEGFR inhibitors have better efficacy and lesser adverse effects in the treatment of ROC. The expression of VEGF/VEGFRs in OC tissue was found to be higher than in benign or normal ovarian tissue. Angiogenesis inhibitors play an essential role in OC treatment. At present, many anti-angiogenic agents have been developed in OC treatment. However, insufficient high-level evidence from systematic reviews (SRs) focused on VEGFRIs for ROC. We performed an SR to investigate the efficacy and safety of VEGFRIs for patients with ROC. Totally 23 RCTs involving 2810 patients were included in this SR. The results demonstrated that VEGFRIs may improve PFS and OS of ROC patients both in platinum-sensitive group and platinum-resistant group. Compared with control groups, using VEGFRIs could significantly improve ORR, DCR and QOL of the patients with ROC. Though VEGFRIs increase some drug-related adverse events (AEs), all the AEs could be manageable in the clinical practice. Based on this study, we recommend VEGFR inhibitors as a reliable therapeutic option in clinical practice for patients with relapsed and refractory OC, which can use alone or in combination with other agents.