Efficacy and safety of PARP inhibitors in the treatment of BRCA-mutated
breast cancer: An updated systematic review and meta-analysis of
randomized controlled trials
Abstract
Aims: Poly-ADP-ribose polymerase inhibitors have emerged as a new class
of therapeutic agents for breast cancer patients with BRCA mutations;
however, the efficacy and toxicity of PARP inhibitors have not been
clearly established. Methods: This study comprehensively evaluated the
efficacy and safety of PARP inhibitors in BRCA mutated breast cancer
patients. Online databases were systematically searched, and six
clinical trials were included in the meta-analysis. The primary endpoint
of efficacy was PFS, secondary endpoints are OS and ORR. In addition, we
also assessed safety. Results: The results of the meta-analysis showed
that PARP inhibitors can effectively improve the PFS, and OS of patients
compared with the control group. The pooled HR (PARP inhibitor vs
control group) was 0.63 (95 % CI, 0.55− 0.73) in PFS and 0.83 (95% CI,
0.73 -0.95) in OS among all patients. In terms of safety, PARP
inhibitors show controllable adverse reactions. There were no
significant differences in overall AEs or grade≥3 AEs between the PARP
inhibitor arms and the control arms. Conclusions: In general, this study
demonstrates PARP inhibitors perform well in both monotherapy and
combination therapy, not only can provide substantial survival benefit,
but also do not increase the additional toxicity burden, and the
clinical application is promising.