Meta-analysis Of Efficacy And Safety Of PARP Inhibitor Combined With Angiogenesis Inhibitor In The Treatment Of Ovarian Cancer

Objective: Summarize and analyze the clinical trial results of existing PARP inhibitors combined with angiogenesis inhibitors in the treatment of ovarian cancer,and evaluate the efficacy and safety of the combination of the two targeted drugs,so as to provide some evidence-based medical evidence for a new targeted treatment scheme for patients with ovarian cancer.Methods: According to the subject words and free words of Mesh database and the PICOS retrieval principle for meta analysis,the search strategy is formulated according to the requirements of major databases,and computers are used in China Knowledge Network（CNKI）,Wanfang,China Biomedical Literature Library（CBM）,VIP,Pub Med,EMBASE,Cochrane Library,web of science and Clinical Trials.gov these domestic and foreign databases to search for the clinical randomized controlled trial of PARP inhibitors combined with angiogenesis inhibitors in the treatment of ovarian cancer.The time range is set from the establishment of the database to December 1,2021.The two evaluators do not interfere with each other and carry out the retrieval of the required documents as required,and strictly screen the retrieved literature according to the inclusion and exclusion criteria formulated in advance.The basic information and data were extracted from the original literature,and the Cochrane quality evaluation tool was used to evaluate the quality of the literature finally included in this study.Finally,the data of progress free survival（PFS）,objective remission rate（ORR）and adverse events（AEs）were statistically analyzed and processed by using Review Manager 5.4 software and Stata 17.0 software.Results: 1.Finally,four studies were included,including two phase II clinical trials and two phase III clinical trials,including five groups of clinical trials.A total of1556 subjects were included,816 in the combined group of PARP inhibitors and angiogenesis inhibitors and 740 in the control group.2.Meta analysis results: in terms of curative effect,compared with the control group,the combination of PARP inhibitors and angiogenesis inhibitors can improve the PFS of patients（HR=0.58,95%CI 0.41-0.80）,P=0.001<0.05,with significant statistical difference;The combination of the two could significantly increase the ORR（RR=1.89,95% CI 1.42-2.53）,P<0.05.The difference was also statistically significant.3.In terms of safety,for major drug AEs,the incidence of vomiting,diarrhea,anorexia,hypertension,headache,dizziness,urinary tract infection,hyponatremia,hoarseness,fatigue,hypothyroidism,cough and palmoplantar swelling syndrome in PARP inhibitor combined with angiogenesis inhibitor was significantly higher than that in the control group（P<0.05）;For serious durg AEs,only the incidence of fatigue in the combined group was significantly higher than that in the control group,and there was no significant difference in the rest.Conclusion: 1.Current research evidence shows that PARP inhibitors combined with angiogenesis inhibitors can prolong PFS and improve ORR in patients with ovarian cancer.2.PARP inhibitors combined with angiogenesis inhibitors can enhance the curative efficacy but it will increase the risk of durg AEs at the same time.3.The AEs with increased risk are mostly grade 1～2.Except for the increase of fatigue,the other AEs with serious risk have no statistical significance,indicating that the combination of drugs is relatively safe.Close observation should be made during clinical combined medication.In case of serious AEs,timely intervention is required to avoid adverse consequences.