Chongqing Municipal Center for Disease Control and Prevention, Chongqing, P.R. China.
Department of Breast and Thyroid Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, P.R. China.
Aging (Albany NY). 2020 Nov 30;13(1):450-459. doi: 10.18632/aging.202152.
Breast cancer is the most commonly diagnosed cancer and is the leading cause of cancer death in women worldwide. Both talazoparib and olaparib are approved by the US Food and Drug Administration for treating (breast cancer 1, early onset)-mutated (human epidermal growth factor receptor 2)-negative metastatic or advanced breast cancer. However, the optimal choice of first-line treatment has not been determined.
To compare the efficacy, safety, and acceptability of single-agent poly (ADP-ribose) polymerase (PARP) inhibitors for patients with -mutated -negative metastatic or advanced breast cancer.
We included two trials comprising 733 participants. Compared with talazoparib, olaparib was not associated with improved PFS ( = 1.08, 95% = 0.34-3.45) or OS ( = 1.18, 95% = 0.61-2.31). Compared with talazoparib, olaparib was associated with non-significantly improved ORR ( = 0.83, 95% = 0.05-12.64). Regarding safety, olaparib had reduced risk for both grade 3-4 anemia ( = 0.34, 95% = 0.003-34.94) and any-grade anemia ( = 0.37, 95% = 0.02-6.81) compared with talazoparib. Olaparib also showed a low risk for grade 3-4 neutropenia ( = 0.57, 95% = 0.06-5.75) compared with talazoparib. Both talazoparib and olaparib were not associated with high risk of treatment discontinuation ( = 0.95, 95% = 0.21-4.47). Regarding time to QoL deterioration, olaparib was associated with short time to clinically meaningful QoL deterioration ( = 1.16, 95% = 0.19-7.17) compared to talazoparib.
Both talazoparib and olaparib have similar efficacy, safety, and acceptability in patients with -mutated -negative metastatic or advanced breast cancer. Well-designed head-to-head randomized controlled trials with large samples are suggested to determine the optimal treatment choice.
We performed a systematic review and network meta-analysis. We performed a systematic search of Web of Science, Embase, PubMed, Medline, ClinicalTrials.gov, the Cochrane Central Register of Controlled Trials, and the World Health Organization International Clinical Trials Registry Platform, and international registers for published and unpublished double-blind randomized controlled trials from database inception to July 20, 2019. The pooled estimates of hazard ratios (HR) with 95% credible intervals (CrIs) were calculated for PFS, OS, and the time to deterioration of quality of life (QoL). The pooled estimates of odds ratio () with 95% CrIs were calculated for ORR, AEs, and treatment discontinuation. This study is registered with PROSPERO (CRD42019138939).
乳腺癌是最常见的癌症，也是全球女性癌症死亡的主要原因。他拉唑帕尼和奥拉帕利均已获得美国食品药品监督管理局批准，用于治疗（乳腺癌 1，早期发病）-突变（人表皮生长因子受体 2）阴性转移性或晚期乳腺癌。然而，尚未确定一线治疗的最佳选择。
比较单药聚（ADP-核糖）聚合酶（PARP）抑制剂治疗 -突变 -阴性转移性或晚期乳腺癌患者的疗效、安全性和可接受性。
我们纳入了两项包含 733 名参与者的试验。与他拉唑帕尼相比，奥拉帕利与无进展生存期（ = 1.08，95% = 0.34-3.45）或总生存期（ = 1.18，95% = 0.61-2.31）的改善无关。与他拉唑帕尼相比，奥拉帕利与客观缓解率（ = 0.83，95% = 0.05-12.64）的非显著改善相关。关于安全性，与他拉唑帕尼相比，奥拉帕利降低了 3-4 级贫血（ = 0.34，95% = 0.003-34.94）和任何级别贫血（ = 0.37，95% = 0.02-6.81）的风险。与他拉唑帕尼相比，奥拉帕利也显示出较低的 3-4 级中性粒细胞减少症风险（ = 0.57，95% = 0.06-5.75）。他拉唑帕尼和奥拉帕利均与治疗中断的高风险无关（ = 0.95，95% = 0.21-4.47）。关于生活质量恶化的时间，与他拉唑帕尼相比，奥拉帕利与 QoL 恶化的临床有意义时间较短（ = 1.16，95% = 0.19-7.17）。
他拉唑帕尼和奥拉帕利在 -突变 -阴性转移性或晚期乳腺癌患者中的疗效、安全性和可接受性相似。建议进行设计良好的头对头随机对照试验，使用大样本量来确定最佳治疗选择。
我们进行了系统评价和网络荟萃分析。我们对 Web of Science、Embase、PubMed、Medline、ClinicalTrials.gov、Cochrane 中心对照试验注册中心和世界卫生组织国际临床试验注册平台进行了系统检索，并对已发表和未发表的双盲随机对照试验进行了国际登记，从数据库建立到 2019 年 7 月 20 日。使用风险比（HR）的 95%可信区间（CrI）计算无进展生存期（PFS）、总生存期（OS）和生活质量（QoL）恶化的时间的汇总估计值。使用优势比（）的 95%CrI 计算客观缓解率（ORR）、AE 和治疗中断的汇总估计值。本研究已在 PROSPERO（CRD42019138939）注册。
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