Objective       To evaluate the efficacy and safety of combination of bevacizumab with first-li

ne chemotherapy in the treatment of metastatic solid tumors.       Methods       Randomized controlled trials on combination of bevacizumab with first-line chemotherapy for metastatic solid tumors were searched in the Cochrane Library

PubMed

EMbase

CNKI

Wangfang Data

etc. The quality of trials was evaluated by 2 reviewers independently

and the software RevMan5.2 was used for Meta-analysis. The outcomes included progression-free survival (PFS)

overall survival (OS) and toxicity.       Results       Sixteen randomized trials with 6 different types of malignancies and 10 917 patients were included in this Meta-analysis. Meta-analysis results suggested that compared with chemotherapy alone

bevacizumab combined with chemotherapy decreased the risk of disease progression （

HR

=0.70

95%

CI

: 0.67 to 0.73

P

<

0.001）and the risk of disease death（

HR

=0.89

95%

CI

: 0.85 to 0.94

P

<

0.001）. The 3/4 grade toxicity analysis showed significant differences were found between the 2 groups in hypertension (

RR

=6.58

95%

CI

：4.97 to 8.71

P

<

0.001)

proteinuria (

RR

=10.85

95%

CI

: 6.33 to 18.61

P

<

0.001) and bleeding (

RR

=1.76

95%

CI

: 1.34 to 2.32

P

<

0.001)

but no significant difference was seen in vein thromboembolic events (

RR

=1.00

95%

CI

: 0.76 to 1.31

P

=0.98) and artery thromboembolic events (

RR

=1.28

95%

CI

: 0.90 to 1.82

P

=0.17).       Conclusion       Bevacizumab plus first-line chemotherapy improves PFS and OS in patients with metastatic solid tumor

but with increased risks in hypertension

proteinuria and bleeding

though without significant increase in thromboembolic events.