Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Mar 11;3(1):14.
doi: 10.1038/s44276-025-00122-9.

Predictive biomarkers for the efficacy of PARP inhibitors in ovarian cancer: an updated systematic review

Ying-Wen Wang  1 , Isaac Allen  2   3   4 , Gabriel Funingana  5 , Marc Tischkowitz  6 , Yvonne Walburga Joko-Fru  6
Affiliations

Predictive biomarkers for the efficacy of PARP inhibitors in ovarian cancer: an updated systematic review

Ying-Wen Wang et al. BJC Rep. .

Abstract

Background: PARP inhibitors are effective in treating ovarian cancer, especially for BRCA1/2 pathogenic variant carriers and those with HRD (homologous recombination deficiency). Concerns over toxicity and costs have led to the search for predictive biomarkers. We present an updated systematic review, expanding on a previous ESMO review on PARP inhibitor biomarkers.

Methods: Following ESMO's 2020 review protocol, we extended our search to March 31, 2023, including PubMed and clinical trial data. We also reviewed the reference lists of review articles. We conducted a meta-analysis using a random-effects model to evaluate hazard ratios and assess the predictive potential of biomarkers and the effectiveness of PARP inhibitors in survival.

Results: We found 375 articles, 103 of which were included after screening (62 primary research, 41 reviews). HRD remained the primary biomarker (95%), particularly BRCA1/2 variants (77%). In the non-HRD category, six articles (10%) introduced innovative biomarkers, including ADP-ribosylation, HOXA9 promoter methylation, patient-derived organoids, KELIM, and SLFN11.

Discussion: Prospective assessment of real-time homologous recombination repair via nuclear RAD51 levels shows promise but needs validation. Emerging biomarkers like ADP-ribosylation, HOXA9 promoter methylation, patient-derived organoids, KELIM, and SLFN11 offer potential but require large-scale validation.

PubMed Disclaimer

Conflict of interest statement

Competing interests: MT is the Editor in Chief of BJC Reports, he was not involved in any aspect of handling of this manuscript or any editorial decisions. Ethics approval and consent to participate: Ethics approval was not required for this review.

Figures

Fig. 1
Fig. 1
The PRISMA workflow.
Fig. 2
Fig. 2. Meta-analysis: predictive biomarkers in PARP inhibitor efficacy.
a BRCA1/2 pathogenic variants and tumour HRD as predictors of PARP Inhibitor efficacy across treatment settings. b BRCA1/2 pathogenic variants and HRD in frontline treatment. c BRCA1/2 pathogenic variants and HRD in recurrent treatment.
Fig. 3
Fig. 3. Decision-making framework for the use of PARP inhibitors in patients with ovarian cancer.
a Decision-making framework for the use of PARP inhibitors in newly diagnosed advanced EOC. b Decision-making framework for the use of PARP inhibitors in platinum-sensitive recurrent EOC. mut mutation, BID twice daily, QD once daily.
See this image and copyright information in PMC

References

    1. Ferlay J, Colombet M, Soerjomataram I, Dyba T, Randi G, Bettio M, et al. Cancer incidence and mortality patterns in Europe: estimates for 40 countries and 25 major cancers in 2018. Eur J Cancer. 2018;103:356–87. - PubMed
    1. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 2022;72:7–33. - PubMed
    1. Torre LA, Trabert B, DeSantis CE, Miller KD, Samimi G, Runowicz CD, et al. Ovarian cancer statistics, 2018. CA Cancer J Clin. 2018;68:284–96. - PMC - PubMed
    1. Lheureux S, Gourley C, Vergote I, Oza AM. Epithelial ovarian cancer. Lancet. 2019;393:1240–53. - PubMed
    1. Burger RA, Brady MF, Bookman MA, Fleming GF, Monk BJ, Huang H, et al. Incorporation of bevacizumab in the primary treatment of ovarian cancer. N Engl J Med. 2011;365:2473–83. - PubMed

LinkOut - more resources