Unveiling the power of PARP inhibitors: a meta-analysis on newly diagnosed advanced ovarian cancer maintenance therapy
This meta-analysis sought to assess the efficacy and safety of poly (adenosine diphosphate-ribose) polymerase inhibitors (PARPi) as maintenance therapy for patients with newly diagnosed advanced ovarian cancer (OC). A comprehensive search was conducted across the PubMed, Medline, EMBASE, Cochrane Library, and Web of Science databases, up to 30 January 2025. Both pairwise meta-analysis and Bayesian network meta-analysis were employed. The primary end points were progression-free survival (PFS) and adverse events (AEs). A total of seven randomized controlled trials, encompassing 11 studies and 3220 patients, were included. PARPi maintenance therapy significantly improved PFS in patients with newly diagnosed OC. Subgroup analysis revealed PFS benefits across BRCA mutations, BRCA wild-type (BRCAwt), homologous recombination deficiency (HRD), and homologous recombination proficiency patients. However, no overall survival (OS) benefit was observed with PARPi maintenance therapy in either the overall or HRD populations. Notably, senaparib showed superior PFS efficacy compared to veliparib and niraparib. Additionally, PARPi treatment was associated with a significantly higher incidence of grade ≥3 AEs. PARPi showed efficacy in improving PFS as maintenance therapy for newly diagnosed advanced OC, although no OS advantage was observed. PROSPERO (CRD420251020275).
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Funding
Health Commission of Hubei Province Scientific Research Project Grant No. WJ2023M068Leading Discipline of Oncology Construction Project of Zhongnan Hospital of Wuhan University Grant No. XKJS202005Youth Interdisciplinary Special Fund of Zhongnan Hospital of Wuhan University Grant ZNQNJC2022003Knowledge Innovation Program of Wuhan-Shuguang Project Grant No. 2023020201020510Translational Medicine and Interdisciplinary Research Joint Fund of Zhongnan Hospital of Wuhan University Grant ZNJC202322Clinical Research Special Fund of Zhongnan Hospital of Wuhan University Grant 2025LCYJZX-MS009Clinical Research Special Fund of Zhongnan Hospital of Wuhan University Grant 2025LCYJZX-ZD005