Impact of Olaparib, Niraparib, Rucaparib therapies on Newly Diagnosed and Relapsed Ovarian Cancer -Systematic Review and Meta-Analysis.

Objective: This review aims to examine the effect of PARP inhibitors on PFS, OS, and adverse events in women with advanced ovarian cancer (OC).

Methods: The PRISMA 2020 guidelines are followed while conducting this comprehensive review. Data from 17 randomized control trails (RCT) published between 2014 and June 2024 were included. These trials compared PARPi maintenance therapy to placebo women with newly diagnosed and recurrent advanced OC. The specific keywords were used to search relevant studies in databases including PubMed, SCOPUS, Cochrane library, and WoS. The main outcomes were the Progression free survival (PFS), overall survival (OS), or adverse events (AEs). The combined hazard ratios (HRs) and risk ratios (RRs) were determined, together with 95% confidence intervals (CIs). Each of the analyses were conducted using a model with random effects.

Results: Despite high heterogeneity, the meta-analysis found that poly (ADP-ribose) polymerase inhibitors (PARPi) maintenance therapy ominously improved PFS compared to placebo, with a combined HR of 1.33 (95% CI: 1.10-1.61) in newly diagnosed cases and 0.88 (95% CI: 0.59-1.30) in relapsed cases. However, the OS improvement was not significantly substantial, with a collective HR of 1.06 (95% CI: 0.99-1.13). AEs are considerably higher in the PARPi groups, notably hematologic toxicities including anaemia, thrombocytopenia, and neutropenia. However, these adverse effects may be controlled with dosage modifications, and therapy was discontinued only in few cases.

Conclusion: PARPi are an effective therapy in both newly discovered and relapsed. Although there is a modest rise in the frequency of severe adverse reactions, they are usually handled well.