Chen Qian, Li Xiaoli, Zhang Zhen, Wu Tong
Department of Pharmacy, Beijing Gaobo Boren Hospital, Beijing, China.
Front Oncol. 2022 Mar 1;12:858826. doi: 10.3389/fonc.2022.858826. eCollection 2022.
To systematically evaluate the efficacy and safety of olaparib in the treatment of recurrent platinum-sensitive ovarian cancer.
The Cochrane Library, PubMed, Chinese Biomedical Literature Database, CNKI, VIP Database, Wanfang Science and Technology Database were searched for randomized controlled trials (RCTs) of olaparib in the treatment of recurrent platinum-sensitive ovarian cancer from the establishment of each database to January 2022. Two reviewers independently evaluated the quality of the literature, extracted the data, and cross-checked the methodological quality. Meta-analysis was performed using RevMan 5.4 software.
A total of 7 RCTs were included, including 2406 patients, There were 1497 patients in treatment groups and 909 patients in the control group. Meta-analysis results showed that in terms of effectiveness, the overall survival time of patients in the olaparib group [HR=1.24, 95%CI(1.06, 1.45), P=0.006]; in terms of safety, for all grades of adverse events (including nausea, fatigue, vomiting, diarrhea, abdominal pain, and headache), [HR=1.54, 95%CI(1.38, 1.71), P=0.0002], for grade 3 or higher adverse events (including nausea, fatigue, vomiting, diarrhea, abdominal pain, and headache), [HR=2.13, 95%CI(1.61, 2.81), P=0.003], there were significant differences compared with the control group, suggesting that the risk of adverse reactions in the experimental group was higher than that in the control group. Subgroup analysis showed that only abdominal pain, headache and vomiting were not statistically significant, and other adverse reactions were statistically significant.
Based on the existing clinical evidence, olaparib in the treatment of recurrent platinum-sensitive ovarian cancer has a longer overall survival than the control group. It is an ideal regimen, but the incidence of adverse reactions is high.
系统评价奥拉帕利治疗复发铂敏感型卵巢癌的疗效和安全性。
检索Cochrane图书馆、PubMed、中国生物医学文献数据库、CNKI、维普数据库、万方科技数据库，查找自各数据库建库至2022年1月期间奥拉帕利治疗复发铂敏感型卵巢癌的随机对照试验（RCT）。两名评价员独立评价文献质量，提取数据，并交叉核对方法学质量。使用RevMan 5.4软件进行Meta分析。
共纳入7项RCT，包括2406例患者，治疗组1497例，对照组909例。Meta分析结果显示，在有效性方面，奥拉帕利组患者的总生存时间[HR=1.24，95%CI（1.06，1.45），P=0.006]；在安全性方面，对于所有级别的不良事件（包括恶心、疲劳、呕吐、腹泻、腹痛和头痛），[HR=1.54，95%CI（1.38，1.71），P=0.0002]，对于3级或更高等级的不良事件（包括恶心、疲劳、呕吐、腹泻、腹痛和头痛），[HR=2.13，95%CI（1.61，2.81），P=0.003]，与对照组相比有显著差异，提示试验组不良反应风险高于对照组。亚组分析显示，仅腹痛、头痛和呕吐无统计学意义，其他不良反应有统计学意义。
基于现有临床证据，奥拉帕利治疗复发铂敏感型卵巢癌的总生存期长于对照组，是一种理想的治疗方案，但不良反应发生率较高。
