The second decade of 2000s is witnessing a new ovarian cancer (OC) paradigm shift thanks to the results recently obtained by a new class of targeted agents: the Poly(ADP-ribose)polymerase (PARP)-Inhibitors (PARPi). Aim of this meta-analysis is to analyze available results obtained with PARPi, administered alone or in combination with chemo- and/or target-therapies in terms of efficacy and safety for the treatment of recurrent and primary advanced OC.
On December 2019, all published phase II/III randomized clinical studies were systematically searched using the terms “[Parp-Inhibitor] AND [ovar*]”. Twelve phase II/III randomized controlled trials were identified, with a total number of 5171 patients included.
Results demonstrated that PARPi account for a significant improvement of PFS in both recurrent and primary OC setting, independently from their administration schedule and independently from patients’ BRCA mutational status. Moreover, patients harboring a Homologous Recombination Deficiency (HRD) positive testing primary or recurrent OC progress significantly later after PARPi administration/association. Results also reported that PARPi increase the occurrence of severe (G3-G4) anemia. Furthermore, severe fatigue occurred more frequently among patients subjected to PARPi combined with chemotherapy and to PARPi plus Bevacizumab. Finally, a significant increase in severe high blood pressure occurrence was observed when PARPi was added to antiangiogenetics, compared to PARPi alone but a significant decrease in G3-G4 hypertension occurrence was found in PARPi plus bevacizumab users compared to Bevacizumab alone.
PARPi are a valid option for the treatment of both primary and relapsed OC patients, with a relative low incidence of severe side effects.
Copyright © 2020 Elsevier Ltd. All rights reserved.
About The Expert
Ilary Ruscito
Filippo Bellati
Isabelle Ray-Coquard
Mansoor Raza Mirza
Andreas du Bois
Maria Luisa Gasparri
Flavia Costanzi
Maria Paola De Marco
Marianna Nuti
Donatella Caserta
Sandro Pignata
Oliver Dorigo
Jalid Sehouli
Elena Ioana Braicu
References
PubMed