Efficacy and safety of PARP inhibitors in patients with BRCA-mutated advanced breast cancer: A meta-analysis and systematic review

被引：11

作者：

Sun, Ximu ^{[2
]}

Wang, Xin ^{[1
]}

Zhang, Jie ^{[1
]}

Zhao, Zhixia ^{[1
]}

Feng, Xin ^{[2
]}

Liu, Lihong ^{[3
]}

Ma, Zhuo ^{[1
]}

机构：

[1] Capital Med Univ, Beijing Chao Yang Hosp, Dept Pharm, 8 Gongren Tiyuchang Nanlu, Beijing 100020, Peoples R China

[2] Capital Med Univ, Beijing Obstet & Gynecol Hosp, Dept Pharm, 17 Qi He Lou St, Beijing 100026, Peoples R China

[3] China Japan Friendship Hosp, Dept Pharm, 2 Yinghuayuan Dongjie, Beijing 100029, Peoples R China

来源：

BREAST | 2021年 / 60卷

关键词：

Poly(ADP-ribose) polymerase inhibitors; Breast cancer; Triple-negative breast cancer; BRCA mutation; OVARIAN-CANCER; DOUBLE-BLIND; MAINTENANCE THERAPY; PLACEBO; OLAPARIB; TOXICITIES; VELIPARIB; SURVIVAL; RISK;

D O I：

10.1016/j.breast.2021.08.009

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Objective: This meta-analysis aimed to investigate the efficacy and safety of poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitors in BRCA-mutated advanced breast cancer patients comprehensively. Methods: We conducted a systematic literature research through PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Embase, China National Knowledge Infrastructure (CNKI), wanfang, China Biology Medicine disc (CBMdisc), and ClinicalTrials.gov from inception to January 2021. Randomized controlled trials (RCTs) with available data comparing PARP inhibitors versus control therapy in BRC-Amutated advanced breast cancer were eligible for analysis. Statistical analyses were performed with Review Manager (RevMan) version 5.4 and R version 4.0.3. Results: 1706 studies were retrieved in total, and 4 RCTs with 1540 patients were eligible for meta-analysis finally. The results showed that progression-free survival (PFS) and overall survival (OS) were significantly improved in germline BRCA-mutated breast cancer patients with PARP inhibitors (HR 0.64, 95% CI [0.56-0.74]; HR 0.86, 95% CI [0.74-0.99], respectively) with no significant heterogeneity across studies (I-2 = 22%, chi(2) p = 0.28; I-2 = 0%, chi(2) p = 0.70, respectively). There was no significant difference in the overall adverse events (AEs), grade >= 3 AEs and AEs leading to treatment discontinuation between PARP inhibitor arms and control arms (RR 1.01, 95% CI [0.99-1.02]; RR 0.95, 95% CI [0.83-1.09]; RR 1.17, 95% CI [0.87-1.57], respectively). Based on the available data, PARP inhibitors provided comparable or better results than control arms in improving the quality of life in BRCA-mutated advanced breast cancer patients. Conclusions: PARP inhibitors prolonged PFS and OS among patients with BRCA-mutated advanced breast cancer with tolerable safety and improved quality of life. (C) 2021 The Authors. Published by Elsevier Ltd.

引用

页码：26 / 34

页数：9

共 34 条

[1] OPERATING CHARACTERISTICS OF A BANK CORRELATION TEST FOR PUBLICATION BIAS [J].

BEGG, CB ;

MAZUMDAR, M .

BIOMETRICS, 1994, 50 (04) :1088-1101

[2] Association Between BRCA1 and BRCA2 Mutations and Survival in Women With Invasive Epithelial Ovarian Cancer [J].

Bolton, Kelly L. ;

Chenevix-Trench, Georgia ;

Goh, Cindy ;

Sadetzki, Siegal ;

Ramus, Susan J. ;

Karlan, Beth Y. ;

Lambrechts, Diether ;

Despierre, Evelyn ;

Barrowdale, Daniel ;

McGuffog, Lesley ;

Healey, Sue ;

Easton, Douglas F. ;

Sinilnikova, Olga ;

Benitez, Javier ;

Garcia, Maria J. ;

Neuhausen, Susan ;

Gail, Mitchell H. ;

Hartge, Patricia ;

Peock, Susan ;

Frost, Debra ;

Evans, Gareth ;

Eeles, Rosalind ;

Godwin, Andrew K. ;

Daly, Mary B. ;

Kwong, Ava ;

Ma, Edmond S. K. ;

Lazaro, Conxi ;

Blanco, Ignacio ;

Montagna, Marco ;

D'Andrea, Emma ;

Nicoletto, Maria Ornella ;

Johnatty, Sharon E. ;

Krueger, Susanne ;

Jensen, Allan ;

Hogdall, Estrid ;

Goode, Ellen L. ;

Fridley, Brooke L. ;

Loud, Jennifer T. ;

Greene, Mark H. ;

Mai, Phuong L. ;

Chetrit, Angela ;

Lubin, Flora ;

Hirsh-Yechezkel, Galit ;

Glendon, Gord ;

Andrulis, Irene L. ;

Toland, Amanda E. ;

Senter, Leigha ;

Gore, Martin E. ;

Gourley, Charlie ;

Michie, Caroline O. .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2012, 307 (04) :382-390

[3]

Breast Cancer Expert Committee of National Cancer Quality Control Center, 2020, ZHONGHUA ZHONG LIU Z, V42, P781, DOI [10.3760/cma.j.cn112152-20200817-00747, DOI 10.3760/CMA.J.CN112152-20200817-00747]

[4] 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) [J].

Cardoso, F. ;

Paluch-Shimon, S. ;

Senkus, E. ;

Curigliano, G. ;

Aapro, M. S. ;

Andre, F. ;

Barrios, C. H. ;

Bergh, J. ;

Bhattacharyya, G. S. ;

Biganzoli, L. ;

Boyle, F. ;

Cardoso, M-J ;

Carey, L. A. ;

Cortes, J. ;

El Saghir, N. S. ;

Elzayat, M. ;

Eniu, A. ;

Fallowfield, L. ;

Francis, P. A. ;

Gelmon, K. ;

Gligorov, J. ;

Haidinger, R. ;

Harbeck, N. ;

Hu, X. ;

Kaufman, B. ;

Kaur, R. ;

Kiely, B. E. ;

Kim, S-B ;

Lin, N. U. ;

Mertz, S. A. ;

Neciosup, S. ;

Offersen, B., V ;

Ohno, S. ;

Pagani, O. ;

Prat, A. ;

Penault-Llorca, F. ;

Rugo, H. S. ;

Sledge, G. W. ;

Thomssen, C. ;

Vorobiof, D. A. ;

Wiseman, T. ;

Xu, B. ;

Norton, L. ;

Costa, A. ;

Winer, E. P. .

ANNALS OF ONCOLOGY, 2020, 31 (12) :1623-1649

[5] Rucaparib maintenance treatment for recurrent ovarian carcinoma after response to platinum therapy (ARIEL3): a randomised, double-blind, placebo-controlled, phase 3 trial [J].

Coleman, Robert L. ;

Oza, Amit M. ;

Lorusso, Domenico ;

Aghajanian, Carol ;

Oaknin, Ana ;

Dean, Andrew ;

Colombo, Nicoletta ;

Weberpals, Johanne, I ;

Clamp, Andrew ;

Scambia, Giovanni ;

Leary, Alexandra ;

Holloway, Robert W. ;

Amenedo Gancedo, Margarita ;

Fong, Peter C. ;

Goh, Jeffrey C. ;

O'Malley, David M. ;

Armstrong, Deborah K. ;

Garcia-Donas, Jesus ;

Swisher, Elizabeth M. ;

Floquet, Anne ;

Konecny, Gottfried E. ;

McNeish, lain A. ;

Scott, Clare L. ;

Cameron, Terri ;

Maloney, Lara ;

Isaacson, Jeff ;

Goble, Sandra ;

Grace, Caroline ;

Harding, Thomas C. ;

Raponi, Mitch ;

Sun, James ;

Lin, Kevin K. ;

Giordano, Heidi ;

Ledermann, Jonathan A. .

LANCET, 2017, 390 (10106) :1949-1961

[6] Veliparib with carboplatin and paclitaxel in BRCA-mutated advanced breast cancer (BROCADE3): a randomised, double-blind, placebo-controlled, phase 3 trial [J].

Dieras, Veronique ;

Han, Hyo S. ;

Kaufman, Bella ;

Wildiers, Hans ;

Friedlander, Michael ;

Ayoub, Jean-Pierre ;

Puhalla, Shannon L. ;

Bondarenko, Igor ;

Campone, Mario ;

Jakobsen, Erik H. ;

Jalving, Mathilde ;

Oprean, Cristina ;

Palacova, Marketa ;

Park, Yeon Hee ;

Shparyk, Yaroslav ;

Yanez, Eduardo ;

Khandelwal, Nikhil ;

Kundu, Madan G. ;

Dudley, Matthew ;

Ratajczak, Christine K. ;

Maag, David ;

Arun, Banu K. .

LANCET ONCOLOGY, 2020, 21 (10) :1269-1282

[7] AGO Recommendations for the Diagnosis and Treatment of Patients with Locally Advanced and Metastatic Breast Cancer: Update 2020 [J].

Ditsch, Nina ;

Untch, Michael ;

Kolberg-Liedtke, Cornelia ;

Jackisch, Christian ;

Krug, David ;

Friedrich, Michael ;

Janni, Wolfgang ;

Mueller, Volkmar ;

Albert, Ute-Susann ;

Banys-Paluchowski, Malgorzata ;

Bauerfeind, Ingo ;

Blohmer, Jens-Uwe ;

Budach, Wilfried ;

Dall, Peter ;

Diel, Ingo ;

Fallenberg, Eva Maria ;

Fasching, Peter A. ;

Fehm, Tanja ;

Gerber, Bernd ;

Gluz, Oleg ;

Hanf, Volker ;

Harbeck, Nadia ;

Heil, Joerg ;

Huober, Jens ;

Kreipe, Hans H. ;

Kuehn, Thorsten ;

Kuemmel, Sherko ;

Loibl, Sibylle ;

Lueftner, Diana ;

Lux, Michael ;

Maass, Nicolai ;

Moebus, Volker ;

Mundhenke, Christoph ;

Park-Simon, Tjoung-Won ;

Reimer, Toralf ;

Rhiem, Kerstin ;

Rody, Achim ;

Schmidt, Marcus ;

Schneeweiss, Andreas ;

Solbach, Chistine ;

Solomayer, Erich-Franz ;

Stickeler, Elmar ;

Thomssen, Christoph ;

Witzel, Isabell ;

Woeckel, Achim ;

Thill, Marc .

BREAST CARE, 2020, 15 (03) :294-309

[8] Bias in meta-analysis detected by a simple, graphical test [J].

Egger, M ;

Smith, GD ;

Schneider, M ;

Minder, C .

BMJ-BRITISH MEDICAL JOURNAL, 1997, 315 (7109) :629-634

[9] Targeting the DNA repair defect in BRCA mutant cells as a therapeutic strategy [J].

Farmer, H ;

McCabe, N ;

Lord, CJ ;

Tutt, ANJ ;

Johnson, DA ;

Richardson, TB ;

Santarosa, M ;

Dillon, KJ ;

Hickson, I ;

Knights, C ;

Martin, NMB ;

Jackson, SP ;

Smith, GCM ;

Ashworth, A .

NATURE, 2005, 434 (7035) :917-921

[10] Moving From Poly (ADP-Ribose) Polymerase Inhibition to Targeting DNA Repair and DNA Damage Response in Cancer Therapy [J].

Gourley, Charlie ;

Balmana, Judith ;

Ledermann, Jonathan A. ;

Serra, Violeta ;

Dent, Rebecca ;

Loibl, Sibylle ;

Pujade-Lauraine, Eric ;

Boulton, Simon J. .

JOURNAL OF CLINICAL ONCOLOGY, 2019, 37 (25) :2257-+

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