PARP inhibitor treatment of advanced breast cancer beyond the BRCA-mutated type: a meta-analysis

Future Oncol. 2021 Jun;17(18):2381-2393. doi: 10.2217/fon-2020-1175. Epub 2021 Mar 31.

Abstract

Background: We conducted this meta-analysis to compare the efficacy and safety of PARP inhibitors with or without chemotherapy versus chemotherapy alone for advanced breast cancer. Methods: A meta-analysis and trial sequential analysis were performed using RevMan 5.2 analysis software. Results: Six eligible randomized clinical trials involving 2080 patients were included. Regimens containing PARP inhibitors were significantly associated with higher objective response rate, longer progression-free survival and overall survival. The PARP inhibitor regimen group had a significantly higher rate of grade ≥3 thrombocytopenia than the chemotherapy-only group. Conclusion: Regimens containing PARP inhibitors are effective and safe for BRCA-mutated advanced breast cancer patients. The efficacy appears to be only marginal in patients with BRCA status unselected.

Keywords: BRCA; PARP; breast cancer; homologous recombination; meta-analysis.

Plain language summary

Lay abstract The present meta-analysis was conducted to compare the efficacy and safety of PARP inhibitors with or without chemotherapy versus chemotherapy alone for advanced breast cancer. Six eligible randomized clinical trials involving 2080 patients were included. Regimens containing PARP inhibitors were significantly associated with higher objective response rate, longer progression-free survival and better overall survival, but a higher rate of grade ≥3 thrombocytopenia. Regimens containing PARP inhibitors are effective and safe for patients with advanced breast cancer who have a BRCA gene mutation. The efficacy appears to be only marginal in patients with BRCA status unselected.

Publication types

  • Meta-Analysis

MeSH terms

  • BRCA1 Protein / genetics*
  • BRCA2 Protein / genetics*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / genetics
  • Breast Neoplasms / pathology
  • Female
  • Humans
  • Mutation*
  • Poly(ADP-ribose) Polymerase Inhibitors / therapeutic use*
  • Prognosis

Substances

  • BRCA1 Protein
  • BRCA1 protein, human
  • BRCA2 Protein
  • BRCA2 protein, human
  • Poly(ADP-ribose) Polymerase Inhibitors