TY - JOUR
T1 - Incorporating Parp-inhibitors in Primary and Recurrent Ovarian Cancer
T2 - A Meta-analysis of 12 phase II/III randomized controlled trials
AU - Ruscito, Ilary
AU - Bellati, Filippo
AU - Ray-Coquard, Isabelle
AU - Mirza, Mansoor Raza
AU - du Bois, Andreas
AU - Gasparri, Maria Luisa
AU - Costanzi, Flavia
AU - De Marco, Maria Paola
AU - Nuti, Marianna
AU - Caserta, Donatella
AU - Pignata, Sandro
AU - Dorigo, Oliver
AU - Sehouli, Jalid
AU - Braicu, Elena Ioana
PY - 2020/7
Y1 - 2020/7
N2 - Background: 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. Methods: 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: 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. Conclusions: PARPi are a valid option for the treatment of both primary and relapsed OC patients, with a relative low incidence of severe side effects.
AB - Background: 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. Methods: 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: 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. Conclusions: PARPi are a valid option for the treatment of both primary and relapsed OC patients, with a relative low incidence of severe side effects.
KW - Niraparib
KW - Olaparib
KW - Ovarian cancer
KW - Parp-inhibitor
KW - Rucaparib
KW - Veliparib
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U2 - 10.1016/j.ctrv.2020.102040
DO - 10.1016/j.ctrv.2020.102040
M3 - Review article
AN - SCOPUS:85085555866
VL - 87
JO - Cancer Treatment Reviews
JF - Cancer Treatment Reviews
SN - 0305-7372
M1 - 102040
ER -