Unveiling the power of PARP inhibitors: A meta-analysis on newly diagnosed advanced ovarian cancer maintenance therapy.

Abstract

e17573 Background: The treatment of ovarian cancer with poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitors (PARPi) is undergoing continuous development. This meta-analysis sought to assess the efficacy and safety of PARPi as maintenance therapy for patients with newly diagnosed advanced ovarian cancer (OC). Methods: A comprehensive search was conducted across the PubMed, Medline, EMBASE, Cochrane Library, and Web of Science databases for randomized controlled trials (RCTs) evaluating the efficacy and safety of PARPi as maintenance therapy in patients with newly diagnosed advanced OC, up to August 30, 2024. Both pairwise meta-analysis and Bayesian network meta-analysis were employed. The primary outcomes assessed were progression-free survival (PFS), overall survival (OS), and adverse events (AEs). Pooled hazard ratios and risk ratios were computed with 95% confidence intervals. Results: A total of seven RCTs, encompassing 3,220 patients, were included in the analysis. The findings indicated that PARPi maintenance therapy significantly enhanced PFS and OS in patients with newly diagnosed OC. Furthermore, an improvement in PFS was observed among patients with BRCA mutations, BRCA wild-type (BRCAwt), homologous recombination deficiency, and homologous recombination proficiency. Notably, in BRCAwt patients, niraparib demonstrated superior efficacy compared to veliparib. Additionally, PARPi treatment was associated with a significantly increased incidence of AEs of grade ≥3. Conclusions: PARPi have demonstrated efficacy as maintenance therapy in patients with newly diagnosed advanced OC. Among patients with BRCAwt tumors, niraparib showed greater effectiveness compared to veliparib.