Khan Muhammad Saad, Khalid Maliha, Farhan Kanza, Chandani Harshika Khaim, Ansari Osaid Ahmed, Chandani Devya Khaim, Khalid Dua, Memon Usama, Waafira Aminath
Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan.
Department of Medicine, Shaheed Mohtarma Benazir Bhutto Medical College, Pakistan.
Ann Med Surg (Lond). 2025 Mar 18;87(4):2336-2345. doi: 10.1097/MS9.0000000000003186. eCollection 2025 Apr.
Patients with epithelial ovarian cancer (EOC) who are treated with niraparib maintenance therapy, experience hematological and gastrointestinal side effects. There is a scarcity of evidence on the safety of niraparib. This study aims to assess the safety profile of niraparib as a maintenance treatment for women with platinum-sensitive EOC.
PubMed (Medline), EMBASE, and Google Scholar were searched for randomized controlled trials (RCTs) with people suffering from EOC. This study used Review Manager and forest plots for visual display. Random effects models were used for this meta-analysis (RRs and 95% CIs).
The study analyzed 2311 cases from 7/8 RCTS of niraparib-treated patients with high risks of any grade of anemia (RR, 3.51; 95% CI, 2.99 to 4.10, < 0.00001) and thrombocytopenia (RR, 13.28; 95% CI, 10.00 to 17.63, < 0.00001). For grade 3 or 4 adverse effects, significantly higher risk was only noted for thrombocytopenia (RR, 32.80; 95% CI, 10.63 to 101.22, < 0.00001), anemia (RR, 14.45; 95% CI, 6.48 to 32.27, < 0.00001) for niraparib-treated patients. Less treatment-related deaths occurred.
There is a need to emphasize on cautious use, hematological toxicities, and personalized dosage regimens of niraparib for improved patient compliance.
接受尼拉帕利维持治疗的上皮性卵巢癌(EOC)患者会出现血液学和胃肠道副作用。关于尼拉帕利安全性的证据较少。本研究旨在评估尼拉帕利作为铂敏感EOC女性维持治疗的安全性。
在PubMed(Medline)、EMBASE和谷歌学术中检索针对EOC患者的随机对照试验(RCT)。本研究使用Review Manager和森林图进行可视化展示。本荟萃分析采用随机效应模型(RRs和95%可信区间)。
该研究分析了来自7/8项尼拉帕利治疗患者的随机对照试验中的2311例病例,这些患者有任何级别贫血(RR,3.51;95%可信区间,2.99至4.10,<0.00001)和血小板减少症(RR,13.28;95%可信区间,10.00至17.63,<0.00001)的高风险。对于3级或4级不良反应,仅在接受尼拉帕利治疗的患者中,血小板减少症(RR,32.80;95%可信区间,10.63至101.22,<0.00001)、贫血(RR,14.45;95%可信区间,6.48至32.27,<0.00001)的风险显著更高。治疗相关死亡较少发生。
需要强调谨慎使用尼拉帕利、血液学毒性以及个性化给药方案,以提高患者依从性。