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Meta-Analysis
. 2020 Jul 4;18(1):151.
doi: 10.1186/s12957-020-01931-7.

The efficacy and safety of the addition of poly ADP-ribose polymerase (PARP) inhibitors to therapy for ovarian cancer: a systematic review and meta-analysis

Yingzhu Yang  1 , Nannan Du  2 , Laidi Xie  3 , Jing Jiang  1 , Jiahang Mo  2 , Jiaze Hong  2 , Danyi Mao  4 , Derry Minyao Ng  5 , Huiwei Shi  6
Affiliations
Meta-Analysis

The efficacy and safety of the addition of poly ADP-ribose polymerase (PARP) inhibitors to therapy for ovarian cancer: a systematic review and meta-analysis

Yingzhu Yang et al. World J Surg Oncol. .

Abstract

Background: The purpose of this study was to explore the efficacy and tolerability of poly ADP-ribose polymerase (PARP) inhibitors in patients with ovarian cancer.

Methods: The meta-analysis searched the PubMed, Web of Science, EBSCO, and Cochrane libraries from inception to February 2020 to identify relevant studies. And the main results of this study were long-term prognosis and treatment-related adverse events.

Results: The results showed that the addition of PARP inhibitors could significantly prolong progression-free survival (PFS) and overall survival (OS) for patients with ovarian cancer (HR 0.44, 95% CI 0.34-0.53, p < 0.001; HR, 0.79, 95% CI 0.65-0.94, p < 0.001, respectively). In the BRCA 1/2 mutation patients, the HR of PFS was 0.29 (p < 0.001), and the HR was 0.51 (p < 0.001) in the no BRCA 1/2 mutation patients. The HR of PFS was 0.40 (p < 0.001) in the homologous recombination deficiency (HRD) mutation patients, while the HR was 0.80 (p < 0.001) in the no HRD mutation patients. Moreover, the analysis found that the use of PARP inhibitors did not significantly increase the risk of all grade adverse events (AEs) (RR = 1.04, p = 0.16). But the incidence of grade 3 or higher AEs was increased (RR = 1.87, p = 0.002). In general, the AEs were mainly manifested in the blood system.

Conclusions: PARP inhibitors can improve the prognosis of ovarian cancer patients with and without genetic mutations (BRCA 1/2 or HRD). Furthermore, PARP inhibitors were tolerable to patients when added to their current therapy, although it inevitably adds the grade 3 and higher AEs.

Keywords: BRCA 1/2; HRD; Meta-analysis; Ovarian cancer; PARP inhibitor.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Forest plots of the progression-free survival (PFS) for additional PARP inhibitors for patients with ovarian cancer (p < 0.001)
Fig. 2
Fig. 2
Forest plots of the progression-free survival (PFS) for additional PARP inhibitors. a BRCA 1/2 mutation (p < 0.001). b no BRCA 1/2 mutation (p < 0.001)
Fig. 3
Fig. 3
Forest plots of the progression-free survival (PFS) for additional PARP inhibitors. a HRD mutation (p < 0.001). b no HRD mutation (p < 0.001)
Fig. 4
Fig. 4
Forest plot of the overall survival (OS) for additional PARP inhibitors for patients with ovarian cancer (p < 0.001)
See this image and copyright information in PMC

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