A Meta-analysis Of The Efficacy And Safety Of Olaparib In The Treatment Of Ovarian Cancer

Objective: To evaluate the efficacy and safety of Olaparib in the treatment of ovarian cancer by Meta-analysis.Methods: Inclusion and exclusion criteria were formulated according to the principles of PICOS(participants,interventions、comparisons、outcomes、study),and computer retrieval was conducted for CBM,CNKI,WANFANG,VIP,Pubmed,Embase,Cochrane library and Web of science.The retrieval time is set from the self-built database to September 2019.The clinical randomized controlled trial(RCTS)of Olaparib in the treatment of ovarian cancer was searched following the "subject + free word" and PICOS search principles.Two evaluators independently and strictly follow the pre-established inclusion and exclusion criteria.The selected studies were evaluated according to the RCT quality criteria recommended by the Cochrane systematic review manual 5.3.0randomized controlled trial quality assessment criteria,and were meta-analyzed using Rev Man5.3 software provided by the Cochrane collaboration and Stata15.0 software.Results: 1.Eventually into seven clinical research,including three Ⅱ phase of clinical trial and four phase III clinical trials,a total of 2282 patients with ovarian cancer.2.The results of meta-analysis showed that compared with the control group,the Olaparib group could improve the PFS of patients(HR=0.46,95%CI 0.41-0.51,P<0.05),which was statistically significant.In OS(HR=0.88,95%CI 0.74-1.04),Olaparib group had an advantage over the control group,but the difference was not statistically significant.3.There was no heterogeneity in PFS(HR=0.39,95%CI 0.33-0.47)and OS(HR=0.92,95%CI 0.71-1.19)between Patients who test positive for the BRCA gene and non-BRCA gene testing.4.Safety analysis showed that Olaparib had a slightly higher risk of grade≥ 3 adverse reactions compared with the control group(RR = 1.61,95%CI 1.23-2.11),which was statistically significant.In the Olaparib group,only fatigue or weakness(RR=2.46,95%CI 1.07-5.66),anemia(RR=22.03,95%CI 6.94-69.95)and neutropenia(RR=2.06,95%CI 1.04-4.08)were found to be at high risk,with statistical significance.The risk reduction was for hypertension(RR=0.61,95%CI 0.48-0.79)RR < 1,which was statistically significant.Most of the residual adverse reactions were grade 1 ~ 2 adverse reactions,which were well tolerated by the patients.Conclusion: 1.Current evidence suggests that Olaparib can improve progression-free survival in ovarian cancer patients,but whether it can extend overall survival is still insufficient and needs to be confirmed by further large-scale and high-quality clinical studies.2.According to the results of this study,the detection of BRCA is not a necessary condition for the application of Olaparib.3.Olaparib group compared with the control group increased the incidence of serious adverse reactions,among them,the serious adverse reactions only statistically significant fatigue or weakness,anemia,neutropenia,4 items of high blood pressure,However,due to the different data collection methods in this study,the statistical results of severe adverse reactions may be underestimated.