Evidence map›Paper›PMID 38851712›Full record

SynthesisBMC cancer2024

The efficacy and safety of PARP inhibitors in mCRPC with HRR mutation in second-line treatment: a systematic review and bayesian network meta-analysis.

Qiyu Zhu, Junru Chen, Haoyang Liu, Jinge Zhao, Chenhao Xu, Guangxi Sun, Hao Zeng

Abstract readSystematic ReviewNetwork Meta-Analysis
In one paragraph

Synthesis in BMC cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Qiyu Zhu *Department of Urology, Institute of Urology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, P.R. China.
Junru Chen *Department of Urology, Institute of Urology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, P.R. China.
Haoyang Liu *Department of Urology, Institute of Urology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, P.R. China.
Jinge ZhaoDepartment of Urology, Institute of Urology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, P.R. China.
Chenhao XuDepartment of Urology, Institute of Urology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, P.R. China.
Guangxi SunDepartment of Urology, Institute of Urology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, P.R. China. sungx077@126.com.
Hao ZengDepartment of Urology, Institute of Urology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, P.R. China. zengh@scu.edu.cn.

Funding

1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University ZYJC21020, ZYGD22004Bethune Foundation, Oncology Basic Research Program X-J-2020-016Bethune Foundation, Urological Oncology Special Research Fund mnzl202002, mnzl202007Clinical and Translational Medicine Research Project, Chinese Academy of Medical Sciences 2022-I2M-C&T-B-098National Natural Science Foundation of China NSFC 82203110, 82172785, and 81974398Sichuan Province Science and Technology Support Program 2021YFS0119
6 · The paper itself

Abstract

backgroundPoly (ADP- ribose) polymerase inhibitors (PARPi) has been increasingly adopted for metastatic castration-resistance prostate cancer (mCRPC) patients with homologous recombination repair deficiency (HRD). However, it is unclear which PARPi is optimal in mCRPC patients with HRD in 2nd -line setting.

methodWe conducted a systematic review of trials regarding PARPi- based therapies on mCRPC in 2nd -line setting and performed a Bayesian network meta-analysis (NMA). Radiographic progression-free survival (rPFS) was assessed as primary outcome. PSA response and adverse events (AEs) were evaluated as secondary outcomes. Subgroup analyses were performed according to specific genetic mutation.

resultsFour RCTs comprised of 1024 patients (763 harbored homologous recombination repair (HRR) mutations) were identified for quantitative analysis. Regarding rPFS, olaparib monotherapy, rucaparib and cediranib plus olaparib showed significant improvement compared with ARAT. Olaparib plus cediranib had the highest surface under cumulative ranking curve (SUCRA) scores (87.5%) for rPFS, followed by rucaparib, olaparib and olaparib plus abiraterone acetate prednisone. For patients with BRCA 1/2 mutations, olaparib associated with the highest probability (98.1%) of improved rPFS. For patients with BRCA-2 mutations, olaparib and olaparib plus cediranib had similar efficacy. However, neither olaparib nor rucaparib showed significant superior effectiveness to androgen receptor-axis-targeted therapy (ARAT) in patients with ATM mutations. For safety, olaparib showed significantly lower ≥ 3 AE rate compared with cediranib plus olaparib (RR: 0.72, 95% CI: 0.51, 0.97), while olaparib plus cediranib was associated with the highest risk of all-grade AE.

conclusionPARPi-based therapy showed considerable efficacy for mCRPC patients with HRD in 2nd -line setting. However, patients should be treated accordingly based on their genetic background as well as the efficacy and safety of the selected regimen.

trial registrationCRD42023454079.

Indexed as

Bayes TheoremMutationPhthalazinesPoly(ADP-ribose) Polymerase InhibitorsProstatic Neoplasms, Castration-ResistantAntineoplastic Combined Chemotherapy ProtocolsBRCA1 ProteinBRCA2 ProteinHumansIndolesMalePiperazinesProgression-Free SurvivalQuinazolinesRandomized Controlled Trials as TopicRecombinational DNA RepairBRCA1 ProteinBRCA2 ProteinBRCA2 protein, humancediranibIndolesolaparibPhthalazinesPiperazinesPoly(ADP-ribose) Polymerase InhibitorsQuinazolinesrucaparibAdverse eventsHomologous recombination deficiencyMetastatic castration-resistance prostate cancerPoly (ADP- ribose) polymerase inhibitorsProgression-free survival

Identifiers

PMID38851712
PMCPMC11162002

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.