Int. Journal of Clinical Pharmacology and Therapeutics

Niraparib-related severe refractory thrombocytopenia in ovarian cancer patients receiving paclitaxel/carboplatin chemotherapy: A report on three cases

A characteristic toxicity of niraparib is a decrease in blood platelets (PLT), with an incidence of ~ 34% for grades 3 - 4 conditions. However, exceedingly severe cases have been reported infrequently. This paper describes three patients with acute and refractory severe PLT deficiency due to niraparib administration. The symptom characteristics, treatment course, and outcomes have also been analyzed, and the potential for the involvement of immune-related factors is considered. Therefore, it is recommended to comprehensively assess bone marrow hematopoietic function and high-risk variables before administering niraparib, intensify self-management and monitoring of patients, track changes in indicators, and intervene promptly. Additionally, if standard PLT-elevating therapies are ineffective, early full-dose administration of thrombopoietin receptor agonists, preferably avatrombopag, may be beneficial for reversing PLT loss of control.

Network pharmacology of ginsenoside Rg3 in the treatment of ovarian cancer: Mechanism of action and experimental verification

The aim of this study was to investigate the mechanism of action of ginsenoside Rg3 (Rg3) in the treatment of ovarian cancer (OC). We used a network pharmacology approach to identify overlapping targets of OC- and Rg3-related genes. The overlapping targets were used for enrichment analysis to construct protein-protein interaction (PPI) networks and identify hub genes. Significantly enriched pathways were validated using in vitro experiments. After identifying the relevant targets of OC and Rg3, 53 overlapping targets were identified. Enrichment analysis revealed that the PI3K-Akt, Ras, Rap1 pathways were significantly enriched. Ten hub genes ( The combination of network pharmacology and in vitro experimental validation revealed that Rg3 may play a therapeutic role in the treatment of OC by promoting the apoptosis of OC cells via the inhibition of the PI3K-Akt signaling pathway. This provides a new idea for the clinical application of Rg3 in the treatment of OC.

Indirect comparison of three PARP inhibitors (olaparib, niraparib, and rucaparib) as maintenance treatment in ovarian carcinoma patients responding to platinum therapy

Evaluation of maintenance treatment with PARP inhibitors in ovarian carcinoma patients responding to platinum therapy: Use of restricted mean survival time as an index of efficacy

Maintenance therapy using poly (ADP-ribose) polymerase inhibitors (PARPIs) is an important therapeutic option in advanced ovarian cancer after platinum-based chemotherapy. We evaluated randomized studies (n = 5) describing the effect of maintenance therapy with PARPIs; they were obtained mainly by searching PubMed. Patient data for the analysis were derived from progression-free survival curves. Restricted mean survival time (RMST) and 95% confidence interval were estimated for individual arms of each trial. The three PARPIs used (olaparib, niraparib, rucaparib) all showed a higher effectiveness than placebo. The gains in progression-free survival were 6 - 8 months. Maintenance therapy studies provide evidence that olaparib, niraparib, rucaparib are effective treatments for advanced ovarian cancer.