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

[11] Breast Cancer, Version 3.2020 [J].

Gradishar, William J. ;

Anderson, Benjamin O. ;

Abraham, Jame ;

Aft, Rebecca ;

Agnese, Doreen ;

Allison, Kimberly H. ;

Blair, Sarah L. ;

Burstein, Harold J. ;

Dang, Chau ;

Elias, Anthony D. ;

Giordano, Sharon H. ;

Goetz, Matthew P. ;

Goldstein, Lori J. ;

Isakoff, Steven J. ;

Krishnamurthy, Jairam ;

Lyons, Janice ;

Marcom, P. Kelly ;

Matro, Jennifer ;

Mayer, Ingrid A. ;

Moran, Meena S. ;

Mortimer, Joanne ;

O'Regan, Ruth M. ;

Patel, Sameer A. ;

Pierce, Lori J. ;

Rugo, Hope S. ;

Sitapati, Amy ;

Smith, Karen Lisa ;

Smith, Mary Lou ;

Soliman, Hatem ;

Stringer-Reasor, Erica M. ;

Telli, Melinda L. ;

Ward, John H. ;

Young, Jessica S. ;

Burns, Jennifer L. ;

Kumar, Rashmi .

JOURNAL OF THE NATIONAL COMPREHENSIVE CANCER NETWORK, 2020, 18 (04) :452-478

[12] Veliparib with temozolomide or carboplatin/paclitaxel versus placebo with carboplatin/paclitaxel in patients with BRCA1/2 locally recurrent/metastatic breast cancer: randomized phase II study [J].

Han, H. S. ;

Dieras, V. ;

Robson, M. ;

Palacova, M. ;

Marcom, P. K. ;

Jager, A. ;

Bondarenko, I. ;

Citrin, D. ;

Campone, M. ;

Telli, M. L. ;

Domchek, S. M. ;

Friedlander, M. ;

Kaufman, B. ;

Garber, J. E. ;

Shparyk, Y. ;

Chmielowska, E. ;

Jakobsen, E. H. ;

Kaklamani, V. ;

Gradishar, W. ;

Ratajczak, C. K. ;

Nickner, C. ;

Qin, Q. ;

Qian, J. ;

Shepherd, S. P. ;

Isakoff, S. J. ;

Puhalla, S. .

ANNALS OF ONCOLOGY, 2018, 29 (01) :154-161

[13]

Harbeck N, 2019, NAT REV DIS PRIMERS, V5, DOI [10.1038/s41572-019-0111-2, 10.1038/s41572-019-0122-z]

[14] The Cochrane Collaboration's tool for assessing risk of bias in randomised trials [J].

Higgins, Julian P. T. ;

Altman, Douglas G. ;

Gotzsche, Peter C. ;

Jueni, Peter ;

Moher, David ;

Oxman, Andrew D. ;

Savovic, Jelena ;

Schulz, Kenneth F. ;

Weeks, Laura ;

Sterne, Jonathan A. C. .

BMJ-BRITISH MEDICAL JOURNAL, 2011, 343

[15] Distinct implications of different BRCA mutations: efficacy of cytotoxic chemotherapy, PARP inhibition and clinical outcome in ovarian cancer [J].

Hollis, Robert L. ;

Churchman, Michael ;

Gourley, Charlie .

ONCOTARGETS AND THERAPY, 2017, 10 :2539-2551

[16] A Population-Based Study of Genes Previously Implicated in Breast Cancer [J].

Hu, Chunling ;

Hart, Steven N. ;

Gnanaolivu, Rohan ;

Huang, Hongyan ;

Lee, Kun Y. ;

Na, Jie ;

Gao, Chi ;

Lilyquist, Jenna ;

Yadav, Siddhartha ;

Boddicker, Nicholas J. ;

Samara, Raed ;

Klebba, Josh ;

Ambrosone, Christine B. ;

Anton-Culver, Hoda ;

Auer, Paul ;

Bandera, Elisa V. ;

Bernstein, Leslie ;

Bertrand, Kimberly A. ;

Burnside, Elizabeth S. ;

Carter, Brian D. ;

Eliassen, Heather ;

Gapstur, Susan M. ;

Gaudet, Mia ;

Haiman, Christopher ;

Hodge, James M. ;

Hunter, David J. ;

Jacobs, Eric J. ;

John, Esther M. ;

Kooperberg, Charles ;

Kurian, Allison W. ;

Le Marchand, Loic ;

Lindstroem, Sara ;

Lindstrom, Tricia ;

Ma, Huiyan ;

Neuhausen, Susan ;

Newcomb, Polly A. ;

O'Brien, Katie M. ;

Olson, Janet E. ;

Ong, Irene M. ;

Pal, Tuya ;

Palmer, Julie R. ;

Patel, Alpa V. ;

Reid, Sonya ;

Rosenberg, Lynn ;

Sandler, Dale P. ;

Scott, Christopher ;

Tamimi, Rulla ;

Taylor, Jack A. ;

Trentham-Dietz, Amy ;

Vachon, Celine M. .

NEW ENGLAND JOURNAL OF MEDICINE, 2021, 384 (05) :440-451

[17] The concept of synthetic lethality in the context of anticancer therapy [J].

Kaelin, WG .

NATURE REVIEWS CANCER, 2005, 5 (09) :689-698

[18] Exploring and comparing adverse events between PARP inhibitors [J].

LaFargue, Christopher J. ;

Dal Molin, Graziela Z. ;

Sood, Anil K. ;

Coleman, Robert L. .

LANCET ONCOLOGY, 2019, 20 (01) :E15-E28

[19] Talazoparib versus chemotherapy in patients with germline BRCA1/2-mutated HER2-negative advanced breast cancer: final overall survival results from the EMBRACA trial [J].

Litton, J. K. ;

Hurvitz, S. A. ;

Mina, L. A. ;

Rugo, H. S. ;

Lee, K-H ;

Goncalves, A. ;

Diab, S. ;

Woodward, N. ;

Goodwin, A. ;

Yerushalmi, R. ;

Roch, H. ;

Im, Y-H ;

Eiermann, W. ;

Quek, R. G. W. ;

Usari, T. ;

Lanzalone, S. ;

Czibere, A. ;

Blum, J. L. ;

Martin, M. ;

Ettl, J. .

ANNALS OF ONCOLOGY, 2020, 31 (11) :1526-1535

[20] Talazoparib in Patients with Advanced Breast Cancer and a Germline BRCA Mutation [J].

Litton, Jennifer K. ;

Rugo, Hope S. ;

Ettl, Johannes ;

Hurvitz, Sara A. ;

Goncalves, Anthony ;

Lee, Kyung-Hun ;

Fehrenbacher, Louis ;

Yerushalmi, Rinat ;

Mina, Lida A. ;

Martin, Miguel ;

Roche, Henri ;

Im, Young-Hyuck ;

Quek, Ruben G. W. ;

Markova, Denka ;

Tudor, Iulia C. ;

Hannah, Alison L. ;

Eiermann, Wolfgang ;

Blum, Joanne L. .

NEW ENGLAND JOURNAL OF MEDICINE, 2018, 379 (08) :753-763

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