BRCA 基因突变的乳腺癌和卵巢癌中的聚腺苷二磷酸核糖聚合酶抑制剂：生存的荟萃分析。

PARP inhibitors in breast and ovarian cancer with BRCA mutations: a meta-analysis of survival.

机构信息

Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, Guangdong, China.

Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China.

出版信息

Aging (Albany NY). 2021 Mar 11;13(6):8975-8988. doi: 10.18632/aging.202724.

OBJECTIVE

To evaluate the efficacy of poly ADP ribose polymerase (PARP) inhibitors (PARPis) in breast and ovarian cancer with (BReast CAncer susceptibility gene) mutation (BRCAm).

METHODS

We conducted a meta-analysis of randomized controlled, phase II or III trials by searching of electronic databases from inception to September 1, 2020. The efficacy of PARPis measured by hazard ratios (HRs) and 95% confidence intervals (95% CIs) for progression free survival (PFS) and overall survival (OS) of patients.

RESULTS

By addition of PARPis to conventional therapy, breast or ovarian cancer patients carrying BRCAm significantly benefited PFS (breast cancer: HR 0.64, 95% CI=0.55-0.75, P<0.001; ovarian cancer: HR 0.33, 95% CI=0.27-0.42, P<0.001), but OS of patients did not increase significantly in these two cancer types (breast cancer: HR 0.87, 95% CI=0.76-1.01, P=0.065; ovarian cancer: HR 0.78, 95% CI=0.61-1.01, P=0.058). For ovarian cancer patients carrying BRCAm, the use of therapy with PARPis yielded longer PFS at the stage of newly diagnosed than the stage of recurrence (22.5 months vs 9.6 months).

CONCLUSION

PARPis were beneficial to all with BRCAm, but they were "most" beneficial to the ovarian cancer subset when administered early after diagnosis, rather than after recurrence.

目的

评估聚 ADP 核糖聚合酶（PARP）抑制剂（PARPi）在携带（乳腺癌易感基因）突变（BRCAm）的乳腺癌和卵巢癌中的疗效。

方法

我们通过检索电子数据库，从建库到 2020 年 9 月 1 日，进行了一项荟萃分析，纳入了随机对照、II 期或 III 期试验。PARPi 治疗患者的无进展生存期（PFS）和总生存期（OS）的疗效通过危险比（HRs）和 95%置信区间（95% CIs）来衡量。

结果

与常规治疗相比，携带 BRCAm 的乳腺癌或卵巢癌患者添加 PARPi 后，PFS 显著获益（乳腺癌：HR 0.64，95% CI=0.55-0.75，P<0.001；卵巢癌：HR 0.33，95% CI=0.27-0.42，P<0.001），但在这两种癌症类型中，患者的 OS 并未显著增加（乳腺癌：HR 0.87，95% CI=0.76-1.01，P=0.065；卵巢癌：HR 0.78，95% CI=0.61-1.01，P=0.058）。对于携带 BRCAm 的卵巢癌患者，PARPi 治疗在初诊时比复发时更能延长 PFS（22.5 个月 vs 9.6 个月）。