Jin Wenfang, Yang Qing, Zhang Zhifeng, Li Jing
College of Pharmacy, Southwest Minzu University, No.16, South 4th Section 1st Ring Road, Chengdu, 610225, Sichuan, PR China.
Eur J Clin Pharmacol. 2025 Jan;81(1):65-81. doi: 10.1007/s00228-024-03771-w. Epub 2024 Nov 5.
To investigate the characteristics of olaparib-associated adverse events (AEs) in cancer patients.
Databases were searched for phase II and III randomized controlled trials (RCTs) involving olaparib treatment up to March 2024. A systematic assessment was performed.
Twenty-seven RCTs involving 9542 patients were included. This meta-analysis indicates that olaparib could significantly increase the risk of developing any all-grade (RR, 1.08; 95% CI, 1.03-1.13; p = 0.001) and high-grade (RR, 1.45; 95% CI, 1.19-1.77; p = 0.0003) AEs in cancer patients. Olaparib could increase the risk of dose reduction (RR, 3.00; 95% CI, 1.59-5.70; p = 0.0007) and treatment discontinuation (RR, 2.00; 95% CI, 1.28-3.14; p = 0.002). Hematologic toxicities and gastrointestinal toxicities commonly occur in patients receiving olaparib. Anemia, nausea, and fatigue were the most frequent AEs, with olaparib increasing the risk of both all-grade and high-grade occurrences of these events. Patients with longer treatment durations tend to have a higher risk of anemia. Patients with urinary system tumors tend to have a higher risk of nausea, while those with breast cancer tend to have a higher risk of fatigue. Olaparib maintenance therapy may be associated with a higher risk of fatigue. Olaparib could increase other AEs such as diarrhea, vomiting, decreased appetite, dyspepsia, dysgeusia, dizziness, headache, back pain, urinary tract infection, dyspnea, and cough.
Olaparib-containing therapy could increase the occurrence of specific AEs in patients with cancer. Clinicians should be aware of these risks and conduct regular monitoring.
探讨奥拉帕利相关不良事件（AE）在癌症患者中的特征。
检索数据库，查找截至2024年3月涉及奥拉帕利治疗的II期和III期随机对照试验（RCT）。进行系统评估。
纳入了27项涉及9542例患者的RCT。该荟萃分析表明，奥拉帕利可显著增加癌症患者发生任何全级别（RR，1.08；95%CI，1.03 - 1.13；p = 0.001）和高级别（RR，1.45；95%CI，1.19 - 1.77；p = 0.0003）AE的风险。奥拉帕利可增加剂量减少（RR，3.00；95%CI，1.59 - 5.70；p = 0.0007）和治疗中断（RR，2.00；95%CI，1.28 - 3.14；p = 0.002）的风险。血液学毒性和胃肠道毒性在接受奥拉帕利治疗的患者中常见。贫血、恶心和疲劳是最常见的AE，奥拉帕利增加了这些事件全级别和高级别发生的风险。治疗持续时间较长的患者贫血风险往往较高。泌尿系统肿瘤患者恶心风险往往较高，而乳腺癌患者疲劳风险往往较高。奥拉帕利维持治疗可能与较高的疲劳风险相关。奥拉帕利可增加其他AE，如腹泻、呕吐、食欲减退、消化不良、味觉障碍、头晕、头痛、背痛、尿路感染、呼吸困难和咳嗽。
含奥拉帕利的治疗可增加癌症患者特定AE的发生。临床医生应意识到这些风险并进行定期监测。
