Meta Analysis Of The Efficacy And Safety Of Poly(ADP-ribose) Polymerase (PARP) Inhibitors In The Treatment Of Ovarian Cancer

Objectives:To evaluate the efficacy and safety of poly(ADP-ribose)polymerase inhibitors in the treatment of ovarian cancer.Methods:By searching Elsevier,PubMed,Medline,CBM,CNKI,WanFang datab-ase,VIP database,etc,the time limit set for the establishment date to December2016.Manual searching magazines of related fields,and with Google,Baidu academic to find relevant documents on the Internet,the cut-off time is December 2016.Collectting the literatures of clinical randomized controlled trials of poly ADP-ribose polymerase(PARP)inhibitors in the treatment of ovarian cancer.First of all,according to the inclusion criterias and exclusion criterias,we screened the literatures,assessed the quality of the literatures,then extracted the relevant datas,and finally used RevMan5.3 software for Meta analysis.Results:A total of four randomized controlled trials were included,involving 599 patients.These randomized controlled trials research different outcomes respectively:the first one is the efficacy and safety of Olaparib(one of PARP inhibitors)in the treatment of recurrent ovarian cancer;the second trial aims to compare Olaparib combined with paclitaxel and carboplatin to paclitaxel and carboplatinin only in the efficacy and safety of the treatment in ovarian cancer;the third trial compares Olaparib with pegylated liposomal doxorubicin in the efficacy and safety of the treatment in recurrent ovarian cancer;the last trial shows the differences between Veliparib(one of PARP inhibitors)plus cyclophosphamide and cyclophosphamide alone in the efficacy and safety of the treatment in ovarian cancer.The Meta-analysis demonstrated that:⑴the datas of efficacy showed that compared with the control group,PARP inhibitor group significantly prolonged progression free survival[HR=0.52,95%CI(0.32,0.85),P=0.009],but had no obvious advantage on OS [HR=1.05,95%CI(0.80,1.36),P=0.74]or ORR[RR=1.13,95%CI(0.90,1.42),P=0.29].⑵the datas of safety showed that in these trials,the common adverse reactions of PARP inhibitors included abdominal pain,diarrhea,nausea,vomiting,fatigue,anemia,etc.Compared with the control group,the experimental group was significantly increased 1-2 level ofadverse reactions,the difference was statistically significant[RR=1.31,95%CI(1.13,1.51),P=0.0003],but 3-4 grade adverse reactions had no significant difference [RR=1.29,95%CI(0.87,1.91),P=0.20].Conclusion:In the treatment of ovarian cancer,PARP inhibitors could improve the progression free survival of patients,with mild adverse reactions,but whether it can prolong overall survival and improve the objective response rate still need to expand the sample to further research.