Comparison of poly (ADP-ribose) polymerase inhibitors (PARPis) as maintenance therapy for newly-diagnosed and platinum-sensitive recurrent ovarian cancer with BRCA mutational status: a systematic review and network meta-analysis.

IF 2.9 3区医学 Q2 ONCOLOGY Expert Review of Anticancer Therapy Pub Date : 2024-01-01 Epub Date: 2024-02-12 DOI:10.1080/14737140.2023.2298832

Shulin Zhou, Yi Jiang, Chengyan Luo, Lin Yuan

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Abstract

Background: Poly(adenosine diphosphate [ADP]-ribose) polymerase inhibitors (PARPi) treatment for ovarian cancer (OC) are ever-changing. This study aimed to compare the efficacy and overall safety of available PARPi as maintenance therapy for BRCA mutation status in patients with newly diagnosed and platinum-sensitive recurrent (PSR) OC patients.

Research design and methods: Relevant RCTs were systematically retrieved from PubMed and Embase until 31 May 2022. Progression-free survival (PFS) and overall survival (OS) based on BRCA mutation status and adverse events (AEs) regardless of mutation were efficacy and safety endpoints.

Results: In newly diagnosed BRCAm-OC patients, olaparib (HR: 0.33; 95% confidence interval [CI]: 0.25, 0.43) and other PARPis [niraparib (HR: 0.40; 95% CI: 0.29, 0.55), rucaparib (HR: 0.40; 95% CI: 0.21, 0.76) and veliparib (HR: 0.44; 95% CI: 0.28, 0.69)] had a statistically significant effect on PFS versus placebo. In BRCAm-PSROC patients, Olaparib exhibited significant benefit (HR: 0.69; 95% CI: 0.54, 0.88) for OS compared to other PARPis. In BRCAwt-PSR OC patients, Olaparib showed a favorable OS benefit than other PARPis (HR: 0.84; 95% CI: 0.57,1.22). Overall, safety profile of all PARPis was acceptable.

Conclusion: All PARPis showed significant benefit, with olaparib showing greater benefit in newly diagnosed and PSR OC women.

Registration: CRD42021288932.

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多聚（ADP-核糖）聚合酶抑制剂（PARPis）作为新诊断和对铂敏感的复发性卵巢癌 BRCA 突变状态维持疗法的比较：系统综述和网络荟萃分析。

背景：聚二磷酸腺苷[ADP]-核糖聚合酶抑制剂（PARPi）治疗卵巢癌（OC）的方法日新月异。本研究旨在比较现有PARPi作为新诊断卵巢癌患者和铂敏感复发（PSR）卵巢癌患者BRCA突变状态维持治疗的疗效和总体安全性：从PubMed和Embase系统检索了截至2022年5月31日的相关RCT。以BRCA突变状态为基础的无进展生存期（PFS）和总生存期（OS），以及不考虑突变的不良事件（AEs）为疗效和安全性终点：在新诊断的BRCAm-OC患者中，奥拉帕利（HR：0.33；95%置信区间[CI]：0.25，0.43）和其他PARPis[尼拉帕利（HR：0.40；95% CI：0.29，0.55）、鲁卡帕利（HR：0.40；95% CI：0.21，0.76）和维利帕利（HR：0.44；95% CI：0.28，0.69）]与安慰剂相比，对PFS有统计学意义的影响。在 BRCAm-PSROC 患者中，与其他 PARPis 相比，Olaparib 对 OS 有明显的益处（HR：0.69；95% CI：0.54，0.88）。在 BRCAwt-PSR OC 患者中，Olaparib 比其他 PARPis 对 OS 更有利（HR：0.84；95% CI：0.57,1.22）。总体而言，所有 PARPis 的安全性均可接受：结论：所有 PARPis 均有明显疗效，其中奥拉帕利对新诊断和 PSR OC 妇女的疗效更大：注册号：CRD42021288932。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Anticancer Therapy 医学-肿瘤学

CiteScore

5.10

自引率

3.00%

发文量

100

审稿时长

4-8 weeks

期刊介绍： Expert Review of Anticancer Therapy (ISSN 1473-7140) provides expert appraisal and commentary on the major trends in cancer care and highlights the performance of new therapeutic and diagnostic approaches. Coverage includes tumor management, novel medicines, anticancer agents and chemotherapy, biological therapy, cancer vaccines, therapeutic indications, biomarkers and diagnostics, and treatment guidelines. All articles are subject to rigorous peer-review, and the journal makes an essential contribution to decision-making in cancer care. Comprehensive coverage in each review is complemented by the unique Expert Review format and includes the following sections: Expert Opinion - a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results Article Highlights – an executive summary of the author’s most critical points.