scholarly journals PARP Inhibitors in Patients With Newly Diagnosed Advanced Ovarian Cancer: A Meta-Analysis of Randomized Clinical Trials

2020 ◽  
Vol 10 ◽  
Author(s):  
Yizi Wang ◽  
Fang Ren ◽  
Zixuan Song ◽  
Xiaoying Wang ◽  
Chiyuan Zhang ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Advanced Ovarian Cancer ◽  
Parp Inhibitors ◽  
Newly Diagnosed

Poly(ADP-ribose) polymerase inhibitors as maintenance treatment in patients with newly diagnosed advanced ovarian cancer: a meta-analysis

2020 ◽  
Vol 16 (10) ◽  
pp. 585-596 ◽  
Author(s):  
Ezzeldin M Ibrahim ◽  
Ahmed A Refae ◽  
Ali M Bayer ◽  
Emad R Sagr
Keyword(s):  
Ovarian Cancer ◽  
Randomized Clinical Trials ◽  
Brca Mutation ◽  
Meta Analysis ◽  
Advanced Ovarian Cancer ◽  
Progression Free Survival ◽  
Recurrent Ovarian Cancer ◽  
Newly Diagnosed ◽  
Free Survival ◽  
Polymerase Inhibitors

Aim: Poly(ADP-ribose) polymerase inhibitors (PARPIs) improved progression-free survival among patients with recurrent ovarian cancer. This meta-analysis examined the effectiveness of PARPIs as maintenance strategy for newly diagnosed patients with advanced high-grade ovarian cancer with or without mutations. Materials & methods: Using defined selection criteria, a literature search identified four eligible randomized clinical trials involving 2386 patients. Results: Compared with placebo maintenance, PARPIs achieved a 46% reduction in the risk of progression or death as compared with placebo (hazard ratio: 0.54; 95% CI: 0.39–0.73; p < 0.0001). That benefit was shown in all clinical subgroups: among those with BRCA mutation, with negative/unknown BRCA mutation, and in those with homologous recombination deficient tumors. Data about the effect on overall survival are still premature. Conclusion: In patients with newly diagnosed advanced ovarian cancer, PARPIs maintenance after standard therapy achieved a significant improvement in progression-free survival as compared with placebo, overall and in all subgroups.

Androgen-deprivation therapy plus docetaxel-based chemotherapy in metastatic hormone-sensitive prostate cancer. A meta-analysis of randomized clinical trials.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 188-188 ◽  
Author(s):  
Allan Ramos-Esquivel ◽  
Joao M. Baptista ◽  
Luis Corrales-Rodriguez ◽  
Ileana Gonzðlez ◽  
Melissa Juarez Villegal ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Clinical Trials ◽  
Androgen Deprivation Therapy ◽  
Metastatic Prostate Cancer ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Androgen Deprivation ◽  
Cochrane Central Register ◽  
Newly Diagnosed ◽  
Hormone Sensitive

188 Background: Androgen-deprivation therapy (ADT) is the standard of treatment for patients with newly diagnosed metastatic prostatic cancer. Nevertheless, recent trials have suggested a role for chemotherapy in these patients. We performed a systematic review and meta-analysis to assess the efficacy and safety of docetaxel-based chemotherapy in combination with ADT for patients with hormone-sensitive metastatic prostate cancer. Methods: Randomized clinical trials (RCT) were identified after systematic searching of electronic databases (MEDLINE, OVID and The Cochrane Central Register of Controlled Trials), as well as ASCO conference proceedings from 2010 to 2015. We included only RCT comparing ADT versus the combination of ADT plus docetaxel-based chemotherapy in patients with newly diagnosed metastatic prostate cancer. A random-effect model was used to determine the pooled hazard ratio (HR) for the efficacy outcomes: overall survival (OS) and clinical progression-free survival (PFS), according to the inverse-variance method. Heterogeneity was measured using the Q and I2statistics. Results: Three RCT (n = 2 262), were included in our meta-analysis (E3805, GETUG-AFU 15 and the M1 subgroup from STAMPEDE Trial). Docetaxel-based chemotherapy plus ADT was associated with improved OS (HR: 0.74; 95% CI: 0.60-0.90; p = 0.003). The heterogeneity of these trials was moderate (Tau2: 0.02; I2: 51%; p = 0.13). Clinical PFS was also significantly better in patients receiving docetaxel-based chemotherapy (HR: 0.67; 95% CI 0.55-0.82; p = 0.0001), with moderate between-study heterogeneity detected (Tau2: 0.01; I2: 42%; p = 0.19). Different subset of patients in these trials can explain the aforementioned heterogeneity. Regarding adverse drug reactions grade 3 or higher, neutropenia was reported in a range from 36% in the GETUG-AFU 15 Trial to 12% in the STAMPEDE trial and febrile neutropenia was reported from 6.1% in the E3805 Trial to 12% in the STAMPEDE Trial. Conclusions: The addition of docetaxel-based chemotherapy to ADT improves OS and clinical PFS. New trials are needed to determine which patients benefit the most from this intervention.

scholarly journals The Impact of Pegylated Liposomal Doxorubicin in Recurrent Ovarian Cancer : An Updated Meta-Analysis of Randomized Clinical Trials

2021 ◽  
Author(s):  
Xin-Ru Li ◽  
Yi Zhu ◽  
Guo-Nan Zhang ◽  
Jian-Ming Huang ◽  
Li-Xia Pei
Keyword(s):  
Ovarian Cancer ◽  
Clinical Trials ◽  
Side Effects ◽  
Confidence Level ◽  
Liposomal Doxorubicin ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Pegylated Liposomal Doxorubicin ◽  
Recurrent Ovarian Cancer ◽  
Cochrane Library

Abstract Background: Pegylated Liposomal Doxorubicin (PLD) could improve the survival rate of patients with recurrent ovarian cancer in previous meta-analysis studies. The aim of the present meta-analysis was to further update the role of PLD in the treatment of recurrent ovarian cancer.Methods: Literature search was performed by using the electronic databases Medicine, EMBASE, Web of Science, and Cochrane library until 27 July 2020. We only restricted the randomized clinical trials. Study specific hazard ratios and 95% confidence level (HR/95% CI), risk ratios and 95% confidence level (RR/95% CI), were pooled using a random effect model. Results: 10 studies (12 trials) were included after screening of 940 articles. We categorized the eligible studies into two groups: the doublet regimens (four trials, 1767 patients) resulted that PLD plus carboplatin(carbo) provided superior progression free survival (PFS) (HR, 0.85; 95% CI, 0.74-0.97) and similar overall survival (OS) (HR, 1.00; 95% CI, 0.88-1.14) compared PAC plus carbo. PLD plus carboplatin was associated with significantly more anemia and Thrombocytopenia, other side effects well-tolerated. In platin resistant patients, the monotherapy regimens (eight trials, 1980 patients) resulted that PLD had similar PFS (HR, 1.02; 95% CI, 0.90–1.16) and OS (HR, 0.88; 95% CI, 0.77–1.01) to other monotherapies. PLD alone was more associated with mucositis/stomatitis and hand-foot syndrome, other side effects well-tolerated.Conclusion: In platinum-sensitive recurrent ovarian cancer, PLD plus carbo is more effective than PAC plus carbo. In platinum-resistant or refractory recurrent ovarian cancer, PLD has similar survival to others monotherapies. For side effects, PLD plus carbo or monotherapy chemotherapy both were well-tolerated.

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