CHEN Yan,JIANG Shuai.Efficacy and safety of olaparib in adjuvant therapy of BRCA1/2 mutated HER2-negative breast cancer: a meta-analysis[J].ZHONGGUO YAOFANG,2023,34(09):1109-1114.
CHEN Yan,JIANG Shuai.Efficacy and safety of olaparib in adjuvant therapy of BRCA1/2 mutated HER2-negative breast cancer: a meta-analysis[J].ZHONGGUO YAOFANG,2023,34(09):1109-1114. DOI: 10.6039/j.issn.1001-0408.2023.09.16.
Efficacy and safety of olaparib in adjuvant therapy of BRCA1/2 mutated HER2-negative breast cancer: a meta-analysis
To systematically evaluate the efficacy and safety of olaparib in adjuvant therapy of breast cancer susceptibility gene (
BRCA
)
1/2
mutated human epidermal growth factor receptor 2 (HER2)-negative breast cancer, and to provide evidence-based reference for clinical treatment.
METHODS
2
Retrieved from CNKI, VIP, Wanfang data, PubMed, ScienceDirect, the Cochrane Library and Embase databases, randomized controlled trials about adjuvant therapy of olaparib (trial group) versus adjuvant therapy of other drugs (control group) were collected. After literature screening and data extraction, meta-analysis, publication bias analysis and sensitivity analysis were performed by using RevMan5.4 software.
RESULTS
2
A total of 5 randomized controlled trials were included, with a total of 2 633 patients, including 1 495 cases in trial group and 1 174 cases in control group. Meta-analysis showed that in terms of efficacy, compared with control group, overall survival [HR=1.02, 95%CI (1.01,1.03),
P
=0.000 8] and progression-free survival [HR=1.78, 95%CI(1.46,2.17),
P
<0.000 01] were longer significantly in the trial group. In terms of safety, compared with the control group, the incidence of adverse drug reactions at any level in the trial group was higher [RR=1.41, 95%CI (1.12, 1.78),
P
=0.004], while there was no statistically significant difference in the incidence of adverse drug reactions above level 3 between the two groups [RR=1.75, 95%CI (0.82, 3.74),
P
=0.15]. The results of publication bias indicated that the possibility of publication bias in this study was relatively low. The results of sensitivity analysis showed that the results obtained in this study were robust.
CONCLUSIONS
2
Compared with patients without adjuvant therapy of olaparib, adjuvant therapy of olaparib can prolong overall survival and progression-free survival of patients with
BRCA1/2
mutated HER2-negative breast cancer, but the risk of adverse drug reactions is relatively high.
关键词
奥拉帕利乳腺癌易感基因人表皮生长因子受体2乳腺癌有效性安全性
Keywords
breast cancer susceptibility genehuman epidermal growth factor receptor 2breast cancerefficacysafety
references
Breast Cancer Association Consortium,DORLING L,CARVALHO S,et al. Breast cancer risk genes-association analysis in more than 113 000 women[J]. N Engl J Med,2021,384(5):428-439.
KUCHENBAECKER K B,HOPPER J L,BARNES D R,et al. Risks of breast,ovarian,and contralateral breast cancer for BRCA1 and BRCA2 mutation carriers[J]. JAMA,2017,317(23):2402-2416.
KAUFMAN B,SHAPIRA-FROMMER R,SCHMUTZLER R K,et al. Olaparib monotherapy in patients with advanced cancer and a germline BRCA1/2 mutation[J]. J Clin Oncol,2015,33(3):244-250.
SLADE D. PARP and PARG inhibitors in cancer treatment[J]. Genes Dev,2020,34(5/6):360-394.
HELLEDAY T. The underlying mechanism for the PARP and BRCA synthetic lethality:clearing up the misunderstandings[J]. Mol Oncol,2011,5(4):387-393.
GAN Y,LI L Q,ZHANG L W,et al. Association between shift work and risk of prostate cancer:a systematic review and meta-analysis of observational studies[J]. Carcinoge- nesis,2018,39(2):87-97.
TUTT A N J,GARBER J E,KAUFMAN B,et al. Adjuvant olaparib for patients with BRCA1- or BRCA2-mutated breast cancer[J]. N Engl J Med,2021,384(25):2394-2405.
ROBSON M,IM S A,SENKUS E,et al. Olaparib for metastatic breast cancer in patients with a germline BRCA mutation[J]. N Engl J Med,2017,377(6):523-533.
IM S A,XU B H,LI W,et al. Olaparib monotherapy for Asian patients with a germline BRCA mutation and HER2-negative metastatic breast cancer:OlympiAD randomized trial subgroup analysis[J]. Sci Rep,2020,10(1):8753.
ROBSON M E,TUNG N,CONTE P,et al. OlympiAD final overall survival and tolerability results:Olaparib versus chemotherapy treatment of physician’s choice in patients with a germline BRCA mutation and HER2-negative metastatic breast cancer[J]. Ann Oncol,2019,30(4):558-566.
FASCHING P A,LINK T,HAUKE J,et al. Neoadjuvant paclitaxel/olaparib in comparison to paclitaxel/carboplatinum in patients with HER2-negative breast cancer and homologous recombination deficiency (GeparOLA study)[J]. Ann Oncol,2021,32(1):49-57.
FELICIO P S,GRASEL R S,CAMPACCI N,et al. Whole-exome sequencing of non-BRCA1/BRCA2 mutation carrier cases at high-risk for hereditary breast/ovarian cancer[J]. Hum Mutat,2021,42(3):290-299.
LI S,SILVESTRI V,LESLIE G,et al. Cancer risks asso- ciated with BRCA1 and BRCA2 pathogenic variants[J]. J Clin Oncol,2022,40(14):1529-1541.
MOMOZAWA Y,SASAI,USUI Y,et al. Expansion of cancer risk profile for BRCA1 and BRCA2 pathogenic variants[J]. JAMA Oncol,2022,8(6):871-878.
LEE A,MOON B I,KIM T H. BRCA1/BRCA2 pathogenic variant breast cancer:treatment and prevention stra- tegies[J]. Ann Lab Med,2020,40(2):114-121.
FOO T K,XIA B. BRCA1-dependent and independent recruitment of PALB2-BRCA2-RAD51 in the DNA damage response and cancer[J]. Cancer Res,2022,82(18):3191-3197.
FU X Y,TAN W,SONG Q B,et al. BRCA1 and breast cancer:molecular mechanisms and therapeutic strategies[J]. Front Cell Dev Biol,2022,10:813457.
ZHUANG J J,CHEN P,WU Y H,et al. Brca1 is regulated by the transcription factor Gata3,and its silencing promotes neural differentiation in retinal neurons[J]. Int J Mol Sci,2022,23(22):13860.
CREMONA M,VANDENBERG C J,FARRELLY A M,et al. BRCA mutations lead to XIAP overexpression and sensitise ovarian cancer to inhibitor of apoptosis (IAP) family inhibitors[J]. Br J Cancer,2022,127(3):488-499.
VARKHEDI M,BARKER V R,EAKINS R A,et al. CNV assessments associated with outcome distinctions for adult and pediatric cancers:loss of BRCA1 in neuroblastoma associates with a lower survival probability[J]. Gene,2022,836:146673.
WANG Y,MA B B,LIU X X,et al. ZFP281-BRCA2 prevents R-loop accumulation during DNA replication[J]. Nat Commun,2022,13(1):3493.
EDAILY S,ABDEL-RAZEQ H. Management strategies of breast cancer patients with BRCA1 and BRCA2 pathogenic germline variants[J]. Onco Targets Ther,2022,15:815-826.
YU J,ZHANG C,SHI W,et al. BRCA2 deficiency increases sensitivity of medulloblastoma to Olaparib by inhibiting RAD51-mediated DNA damage repair system[J]. Clin Transl Oncol,2022,24(5):919-926.
GUPTA T,VINAYAK S,TELLI M. Emerging strategies:PARP inhibitors in combination with immune checkpoint blockade in BRCA1 and BRCA2 mutation-associated and triple-negative breast cancer[J]. Breast Cancer Res Treat,2023,197(1):51-56.
LUO L J,KEYOMARSI K. PARP inhibitors as single agents and in combination therapy:the most promising treatment strategies in clinical trials for BRCA-mutant ovarian and triple-negative breast cancers[J]. Expert Opin Investig Drugs,2022,31(6):607-631.
WANG Q W,BERGHOLZ J S,DING L Y,et al. STING agonism reprograms tumor-associated macrophages and overcomes resistance to PARP inhibition in BRCA1-deficient models of breast cancer[J]. Nat Commun,2022,13(1):3022.
MENEZES M C S,RAHEEM F,MINA,et al. PARP inhibitors for breast cancer:germline BRCA1/2 and beyond[J]. Cancers (Basel),2022,14(17):4332.
LAU C H,SEOW K M,CHEN K H. The molecular mechanisms of actions,effects,and clinical implications of PARP inhibitors in epithelial ovarian cancers:a syste- matic review[J]. Int J Mol Sci,2022,23(15):8125.
WANG Y J,LUO W B,WANG Y F. PARP-1 and its associated nucleases in DNA damage response[J]. DNA Repair (Amst),2019,81:102651.
WILSON Z,ODEDRA R,WALLEZ Y,et al. ATR inhibitor AZD6738 (ceralasertib) exerts antitumor activity as a monotherapy and in combination with chemotherapy and the PARP inhibitor olaparib[J]. Cancer Res,2022,82(6):1140-1152.
KIM D,NAM H J. PARP inhibitors:clinical limitations and recent attempts to overcome them[J]. Int J Mol Sci,2022,23(15):8412.
Efficacy and safety comparison of lacosamide and carbamazepine in the treatment of adult patients with newly diagnosed epilepsy
Efficacy and safety of antibody-drug conjugates in the treatment of breast cancer:a meta-analysis
Efficacy and safety of aerosol inhalation of polycolistin B in patients with severe pneumonia combined with mechanical ventilation
Research progress of furmonertinib for EGFR-mutated non-small cell lung cancer
Efficacy and safety of parecoxib versus ketorolac tromethamine for perioperative analgesia: a systematic review
Related Author
GUO Xiaqing
LI Guofei
SUN Yuhua
ZHENG Donglin
XU Yinxue
ZHANG Lei
QIAO Xiwen
SHEN Xiaolan
Related Institution
First Ward, Dept. of Neurology, Huaihe Hospital of Henan University
Dept. of Pharmacy, the Affiliated Jiangsu Shengze Hospital of Nanjing Medical University
Dept. of Clinical Pharmacy, the First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Shandong Medicine and Health Key Laboratory of Clinical Pharmacy
Center for Big Data Research in Health and Medicine, the First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital
Key Specialty of Clinical Pharmacy, the First Affiliated Hospital of Guangdong Pharmaceutical University