PARP inhibitors as maintenance therapy in newly diagnosed advanced ovarian cancer: a meta‐analysis
Background
Up to 70% of patients with advanced ovarian cancer have a relapse after primary therapy. New agents and approaches are urgently needed to avoid or slow down this recurrence.
Objectives
To investigate the efficacy of PARP inhibitors (PARPis) as maintenance treatment in patients with newly diagnosed advanced ovarian cancer.
Search strategy
PubMed, MEDLINE, EMBASE, Cochrane Library and Web of Science databases.
Selection criteria
All randomised clinical trials (RCTs) that compared PARPis with placebo as first‐line maintenance therapy in ovarian cancer.
Data collection and analysis
Two reviewers extracted data. Pooled hazard ratio (HR) and risk ratio (RR) with 95% confidence interval (CI) were calculated.
Main results
PARPis were associated with significant improvement of progression‐free survival (PFS) in advanced epithelial ovarian cancer (AeOC) (HR = 0.53, 95% CI 0.40–0.71; P < 0.0001). The benefit was not only in women with BRCA mutations (HR = 0.35, 95% CI 0.29–0.42; P < 0.00001) and homologous recombination deficiency (HRD) (HR = 0.43, 95% CI 0.32–0.60; P < 0.00001), but also in those with nonmutated BRCA (HR = 0.72, 95% CI 0.63–0.82; P < 0.00001) and even non‐HRD (HR = 0.83, 95% CI 0.70–0.99; P = 0.04).
Conclusions
PARP inhibitors are effective as maintenance therapy among patients with newly diagnosed advanced ovarian cancer after platinum‐based chemotherapy, regardless of BRCA mutation or HRD status.
Tweetable abstract
PARPis provide a significant PFS benefit as first‐line maintenance therapy in patients with newly diagnosed advanced ovarian cancer.