TY - JOUR
T1 - Bevacizumab or PARP-Inhibitors maintenance therapy for platinum-sensitive recurrent ovarian cancer
T2 - A network meta-analysis
AU - Bartoletti, Michele
AU - Pelizzari, Giacomo
AU - Gerratana, Lorenzo
AU - Bortot, Lucia
AU - Lombardi, Davide
AU - Nicoloso, Milena
AU - Scalone, Simona
AU - Giorda, Giorgio
AU - Baldassarre, Gustavo
AU - Sorio, Roberto
AU - Puglisi, Fabio
N1 - Funding Information:
Conflicts of Interest: F.P. reports grants from AstraZeneca; grants, personal fees, and other from Roche; personal fees and other from Eli Lilly; personal fees from Amgen; personal fees from Ipsen; personal fees from MSD; personal fees from Takeda; grants and other from Eisai; other from Novartis and Pfizer, outside the submitted work. L.G. reports personal fees from Eli lilly, outside the submitted work. The other authors have nothing to disclose.
Publisher Copyright:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/6/1
Y1 - 2020/6/1
N2 - Introduction: Targeted agents such as bevacizumab (BEV) or poly (ADP-ribose) polymerase inhibitors (PARPi) which have been added as concomitant or maintenance therapies have been shown to improve progression-free survival (PFS) in patients with platinum-sensitive recurrent ovarian cancer (PS rOC). In the absence of direct comparison, we performed a network meta-analysis considering BRCA genes status. Methods: We searched PubMed, EMBASE, and MEDLINE for trials involving patients with PS rOC treated with BEV or PARPi. Different comparisons were performed for patients included in the PARPi trials, according to BRCA genes status as follows: all comers (AC) population, BRCA 1/2 mutated (BRCAm), and BRCA wild type patients (BRCAwt). Results: In the overall population, PARPi prolonged PFS with respect to BEV (hazard ratio (HR) = 0.70, 95% CI 0.54-0.91). In the BRCA mutated carriers, the PFS improvement in favor of PARPi appeared to be higher (HR = 0.46, 95% CI 0.36-0.59) while in BRCAwt patients the superiority of PARPi over BEV failed to reach a statistically significance level (HR = 0.87, 95% CI 0.63-1.20); however, according to the SUCRA analysis, PARPi had the highest probability of being ranked as the most effective therapy (90% and 60%, for PARPi and BEV, respectively). Conclusions: PARPi performed better as compared with BEV in terms of PFS for the treatment of PS rOC, especially in BRCAm patients who had not previously received PARPi.
AB - Introduction: Targeted agents such as bevacizumab (BEV) or poly (ADP-ribose) polymerase inhibitors (PARPi) which have been added as concomitant or maintenance therapies have been shown to improve progression-free survival (PFS) in patients with platinum-sensitive recurrent ovarian cancer (PS rOC). In the absence of direct comparison, we performed a network meta-analysis considering BRCA genes status. Methods: We searched PubMed, EMBASE, and MEDLINE for trials involving patients with PS rOC treated with BEV or PARPi. Different comparisons were performed for patients included in the PARPi trials, according to BRCA genes status as follows: all comers (AC) population, BRCA 1/2 mutated (BRCAm), and BRCA wild type patients (BRCAwt). Results: In the overall population, PARPi prolonged PFS with respect to BEV (hazard ratio (HR) = 0.70, 95% CI 0.54-0.91). In the BRCA mutated carriers, the PFS improvement in favor of PARPi appeared to be higher (HR = 0.46, 95% CI 0.36-0.59) while in BRCAwt patients the superiority of PARPi over BEV failed to reach a statistically significance level (HR = 0.87, 95% CI 0.63-1.20); however, according to the SUCRA analysis, PARPi had the highest probability of being ranked as the most effective therapy (90% and 60%, for PARPi and BEV, respectively). Conclusions: PARPi performed better as compared with BEV in terms of PFS for the treatment of PS rOC, especially in BRCAm patients who had not previously received PARPi.
KW - Bevacizumab
KW - PARP-inhibitors
KW - Platinum-sensitive ovarian cancer
UR - http://www.scopus.com/inward/record.url?scp=85085713108&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85085713108&partnerID=8YFLogxK
U2 - 10.3390/ijms21113805
DO - 10.3390/ijms21113805
M3 - Article
C2 - 32471250
AN - SCOPUS:85085713108
VL - 21
JO - International Journal of Molecular Sciences
JF - International Journal of Molecular Sciences
SN - 1661-6596
IS - 11
M1 - 3805
ER -