Huang Xuemei, Luo Jianxiu, Gu Liqin
Department of Gynecology, Ganzhou People's Hospital, Ganzhou, Jiangxi 341000, P.R. China.
Oncol Lett. 2024 Oct 29;29(1):36. doi: 10.3892/ol.2024.14782. eCollection 2025 Jan.
Ovarian cancer is a leading cause of mortality among women with gynecological malignancies, largely due to its asymptomatic nature in early stages and frequent late diagnosis. Targeted therapies, such as angiogenesis inhibitors and poly(ADP-ribose) polymerase inhibitors (PARPi), have emerged as promising treatments by disrupting tumor vasculature and impairing DNA repair mechanisms, particularly in patients with BRCA mutations. The objective of the present study was to comprehensively evaluate the combined use of different angiogenesis inhibitors and PARPi in ovarian cancer treatment by meta-analysis. This included assessing their impact on objective response rate (ORR) and progression-free survival (PFS), understanding the role of BRCA mutation status, and comparing the effects of various angiogenesis inhibitors when used in combination with PARPi. The PubMed, Embase and Cochrane databases were searched from inception to February 2024. Only studies on the combined treatment of ovarian cancer with angiogenesis inhibitors and PARPi were included. Duplicate studies, studies with incomplete data, animal studies, literature reviews and systematic studies were excluded. The results underscored a noteworthy improvement in the ORR and median PFS (mPFS) among patients receiving combination therapy compared with those on monotherapy. Specifically, the pooled ORR for combination therapy was significantly higher than that of monotherapy, indicating a substantial benefit in terms of tumor response. Furthermore, combination therapy was found to significantly prolong PFS, offering patients a longer duration without disease progression. Subgroup analyses of patients treated with angiogenesis inhibitors combined with PARPi provided deeper insights, revealing that patients with BRCA mutations exhibited an ORR of 90% compared with 61% in those without BRCA mutations. Additionally, when different angiogenesis inhibitors were compared, patients treated with anti-VEGF agents combined with PARPi showed a longer mPFS (15.53 months) than those treated with TKIs combined with PARPi (7.49 months). In conclusion, the present study demonstrates that combinations of angiogenesis inhibitors and PARPi show great potential for improving treatment outcomes in ovarian cancer, particularly in patients with BRCA mutations. The observed differences in efficacy between various angiogenesis inhibitors highlight the importance of personalized treatment approaches. Further research is warranted to explore the long-term benefits of these combination strategies and refine them to obtain optimal patient outcomes.
卵巢癌是妇科恶性肿瘤中导致女性死亡的主要原因之一，这在很大程度上归因于其早期无症状的特性以及常常出现的晚期诊断情况。靶向治疗，如血管生成抑制剂和聚（ADP - 核糖）聚合酶抑制剂（PARPi），已成为有前景的治疗方法，通过破坏肿瘤血管系统和损害DNA修复机制来发挥作用，尤其是在携带BRCA突变的患者中。本研究的目的是通过荟萃分析全面评估不同血管生成抑制剂和PARPi联合用于卵巢癌治疗的效果。这包括评估它们对客观缓解率（ORR）和无进展生存期（PFS）的影响，了解BRCA突变状态的作用，以及比较各种血管生成抑制剂与PARPi联合使用时的效果。从数据库建立到2024年2月对PubMed、Embase和Cochrane数据库进行了检索。仅纳入关于血管生成抑制剂和PARPi联合治疗卵巢癌的研究。排除重复研究、数据不完整的研究、动物研究、文献综述和系统评价。结果强调，与接受单一疗法的患者相比，接受联合治疗的患者在ORR和中位PFS（mPFS）方面有显著改善。具体而言，联合治疗的汇总ORR显著高于单一疗法，表明在肿瘤反应方面有实质性益处。此外，发现联合治疗可显著延长PFS，为患者提供更长的无疾病进展时间。对接受血管生成抑制剂联合PARPi治疗的患者进行亚组分析提供了更深入的见解，显示携带BRCA突变的患者ORR为90%，而未携带BRCA突变的患者为61%。此外，当比较不同的血管生成抑制剂时，接受抗VEGF药物联合PARPi治疗的患者mPFS（15.53个月）比接受TKIs联合PARPi治疗的患者（7.49个月）更长。总之，本研究表明血管生成抑制剂和PARPi联合使用在改善卵巢癌治疗结果方面具有巨大潜力，特别是在携带BRCA突变的患者中。各种血管生成抑制剂之间观察到的疗效差异凸显了个性化治疗方法的重要性。有必要进一步研究以探索这些联合策略的长期益处并对其进行优化，以获得最佳的患者治疗效果。
