Poly (ADP-ribose) Polymerase (PARP) Inhibitors For The Treatment Of Recurrent Epithelial Ovarian Cancer:a Meta-analysis

Objective:Objective to evaluate the efficacy and risk of Poly(ADP-ribose)polymerase(PARP)inhibitors in the treatment of recurrent epithelial ovarian cancer,and to provide more effective and safer treatment for them.Methods:We searched the CBM,CNKI,Wanfang database,NCBI,Cochrane Library,Medline database by computer for studies from beginning to February 28,2017 that evaluate the efficacy and risk of Poly(ADP-ribose)polymerase(PARP)inhibitors in the treatment of recurrent epithelial ovarian cancer.All studies included were randomly controlled clinical trials.The quality of the research was evaluated Acco rding to the RCT standard recommended by the 5.3 edition of the Cochrane system evaluation manual and the Revman5.3 software provided by Cochrane collaborat ion network was used for Meta analysis.The complicated statistic of overall surv ival(OS)and progression free survival(PFS)was hazard ratio(HR),The complicated statistic of adverse events and objective response rate(ORR)was relative ratio(RR).Results:Searching related literatures until February 28,2017.a total of 4 RCT studies,including 3 phase II trials and 1 phase III clinical trials,A total of 997 patientswith recurrent ovarian cancer from all over the world,including 420 people in the BRCA mutation were included in the study.Meta analysis showed that Compa red with the control group,Poly(ADP-ribose)polymerase(PARP)inhibitors can significantly improve the progression free survival(PFS)of patients(HR0.51 95%CI 0.34-0.77 P<0.0001).Especially for patients of BRCA mutants(HR0.31 95%CI 0.16-0.61 P=0.0008).However,there was no significant improvement in overall survival(OS)(all HR 0.99 95%CI 0.78-1.25 P=0.94;Mutation HR0.76 95%CI 0.45-1.31P=0.96).Analysis of adverse reactions showed that main adverse events of Poly(A DP-ribose)polymerase(PARP)inhibitors was Nausea,fatigue,vomiting,diarrhea,abdominal pain,anemia,constipation,and so on,mainly for the 1-2 reaction.Fatigue,vomiting,nausea,anemia,neutropenia were statistically significant between groups at all levels,but only anemia and neutropenia at the level of 3-4(need drug intervention)was statistically significant between the two groups.Conclusion:Analysis revealed that Poly(ADP-ribose)polymerase(PARP)inhibitors can significantly improve progression free survival(PFS)in patients with recurrent epithelial ovarian cancer(ROC),Especially for patients with BRCA mutations,and the im provement for the overall survival(OS)was no clear evidences,we need more further research and data validation.PARP inhibitors may cause nausea,fatigue,vomiting,diarrhea,abdominal pain,constipation,anemia,neutropenia and other adver seevents in the clinical application,and anemia and neutropenia were the most significant,which need to cause clinical attention.