Cancer Management and Research (Aug 2018)
The efficacy and safety of olaparib in the treatment of cancers: a meta-analysis of randomized controlled trials
Abstract
Xiao Xia Guo,1,* Hong Li Wu,2,* Hong Yun Shi,3 Lei Su,3 Xi Zhang3 1Department of Obstetrics and Gynecology, Sichuan Academy of Medical Sciences, Sichuan Provincial People’s Hospital, Chengdu, 2Department of Obstetrics and Gynecology, Hebei University Affiliated Hospital, 3Department of Radiation Oncology, Hebei University Affiliated Hospital, Baoding, China *These authors contributed equally to this work Purpose: PARP inhibition is an exciting new anticancer strategy. As the first PARP inhibitor approved for the treatment of advanced BRCA-mutated ovarian cancer, olaparib has proven to be effective in the treatment of several solid tumors. We performed a meta-analysis of published randomized controlled trials to evaluate the efficacy and safety of olaparib in cancer patients. Methods: PubMed, Embase, and oncology-conference proceedings were searched for relevant studies. End points were overall survival (OS), progression-free survival (PFS), overall response rate (ORR), and grade 3/4 adverse events. Pooled hazard ratio (HR)/risk ratio (RR) and 95% CI were calculated using random or fixed-effect models. Results: Eight trials involving 1,957 patients were ultimately identified. The pooled analysis demonstrated that olaparib treatment significantly improved PFS (HR 0.62, 95% CI 0.47–0.82; P=0.001), OS (HR 0.82, 95% CI 0.73–0.93; P=0.001), and ORR (RR 1.38, 95% CI 1.16–1.65; P<0.001) when compared with therapy not containing olaparib. This association was further confirmed by sensitivity analysis. Additionally, olaparib treatment offered a significant survival benefit for patients with BRCA mutation. Moreover, treatment with olaparib was associated with a significant increase in risk of severe anemia. Conclusion: Olaparib treatment has better treatment response compared with therapy not containing olaparib, whereas olaparib can increase the risk of severe anemia. Keywords: olaparib, efficacy, safety, cancers, meta-analysis, RCTs
