Efficacy and Safety of Poly (ADP-Ribose) Polymerase Inhibitors in Combination with Chemotherapy for Advanced Breast Cancer: A Systematic Review and Meta-Analysis

Purpose To comprehensively evaluate the efficacy and safety of combining poly (ADP-ribose) polymerase (PARP) inhibitors with chemotherapy in patients with advanced breast cancer. Methods A systematic literature search was conducted in PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTri...

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Main Authors: Qiuhua Duan MM, Yue Feng MM, Lichen Cao MM, Lijun Hu PhD, Jianlin Wang PhD, Fei Sun PhD, Qinghong Meng, Mengyun Zhou MM, Jingping Yu PhD, Haiyan Gao PhD
Format: Article
Language:English
Published: SAGE Publishing 2025-06-01
Series:Technology in Cancer Research & Treatment
Online Access:https://doi.org/10.1177/15330338251350630
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author Qiuhua Duan MM
Yue Feng MM
Lichen Cao MM
Lijun Hu PhD
Jianlin Wang PhD
Fei Sun PhD
Qinghong Meng
Mengyun Zhou MM
Jingping Yu PhD
Haiyan Gao PhD
author_facet Qiuhua Duan MM
Yue Feng MM
Lichen Cao MM
Lijun Hu PhD
Jianlin Wang PhD
Fei Sun PhD
Qinghong Meng
Mengyun Zhou MM
Jingping Yu PhD
Haiyan Gao PhD
author_sort Qiuhua Duan MM
collection DOAJ
description Purpose To comprehensively evaluate the efficacy and safety of combining poly (ADP-ribose) polymerase (PARP) inhibitors with chemotherapy in patients with advanced breast cancer. Methods A systematic literature search was conducted in PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov to identify randomized controlled trials (RCTs) evaluating PARP inhibitor-chemotherapy combinations. Studies reporting progression-free survival (PFS), overall survival (OS), overall response rate (ORR), and safety outcomes were included. Data extraction and quality assessment were performed independently by two reviewers, and a meta-analysis was conducted using random-effects models. Results Of 970 studies retrieved, four RCTs involving 1064 patients met the inclusion criteria. PARP inhibitors combined with chemotherapy significantly improved PFS (hazard ratio [HR] 0.73, 95% confidence interval [CI] 0.63-0.84, P  < .0001) and showed a trend towards improved OS (HR 0.93, 95% CI 0.79-1.09, P  = .36), though this was not statistically significant. There was no significant improvement in ORR (RR 1.08, 95% CI 0.98-1.20, P  = .13). Regarding safety, no significant difference was observed in all grades or grade 3-4 adverse events (AEs) overall, but the combination therapy was associated with an increased risk of anemia, nausea, and diarrhea (RRs ranging from 1.14 to 1.29, all P  < .01). Conclusion PARP inhibitor combined with chemotherapy is an effective option for the treatment of patients with advanced breast cancer, but its potential increased risks of specific AEs need to be weighed. Clinicians should make individualized treatment plans according to the specific conditions of patients, comprehensive consideration of efficacy and safety.
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spelling doaj-art-24144afc2b59410285befc6d06ea7de42025-08-20T03:45:36ZengSAGE PublishingTechnology in Cancer Research & Treatment1533-03382025-06-012410.1177/15330338251350630Efficacy and Safety of Poly (ADP-Ribose) Polymerase Inhibitors in Combination with Chemotherapy for Advanced Breast Cancer: A Systematic Review and Meta-AnalysisQiuhua Duan MM0Yue Feng MM1Lichen Cao MM2Lijun Hu PhD3Jianlin Wang PhD4Fei Sun PhD5Qinghong Meng6Mengyun Zhou MM7Jingping Yu PhD8Haiyan Gao PhD9 Department of Radiation Oncology, , Changzhou, China Department of Radiation Oncology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China Department of Breast Surgery, , Changzhou, China Department of Radiation Oncology, , Changzhou, China Department of Radiation Oncology, , Changzhou, China Department of Radiation Oncology, , Changzhou, China Department of Radiation Oncology, , Changzhou, China Department of Radiation Oncology, , Changzhou, China Department of Hospital Administration, , Changzhou, China Department of Breast Surgery, , Changzhou, ChinaPurpose To comprehensively evaluate the efficacy and safety of combining poly (ADP-ribose) polymerase (PARP) inhibitors with chemotherapy in patients with advanced breast cancer. Methods A systematic literature search was conducted in PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov to identify randomized controlled trials (RCTs) evaluating PARP inhibitor-chemotherapy combinations. Studies reporting progression-free survival (PFS), overall survival (OS), overall response rate (ORR), and safety outcomes were included. Data extraction and quality assessment were performed independently by two reviewers, and a meta-analysis was conducted using random-effects models. Results Of 970 studies retrieved, four RCTs involving 1064 patients met the inclusion criteria. PARP inhibitors combined with chemotherapy significantly improved PFS (hazard ratio [HR] 0.73, 95% confidence interval [CI] 0.63-0.84, P  < .0001) and showed a trend towards improved OS (HR 0.93, 95% CI 0.79-1.09, P  = .36), though this was not statistically significant. There was no significant improvement in ORR (RR 1.08, 95% CI 0.98-1.20, P  = .13). Regarding safety, no significant difference was observed in all grades or grade 3-4 adverse events (AEs) overall, but the combination therapy was associated with an increased risk of anemia, nausea, and diarrhea (RRs ranging from 1.14 to 1.29, all P  < .01). Conclusion PARP inhibitor combined with chemotherapy is an effective option for the treatment of patients with advanced breast cancer, but its potential increased risks of specific AEs need to be weighed. Clinicians should make individualized treatment plans according to the specific conditions of patients, comprehensive consideration of efficacy and safety.https://doi.org/10.1177/15330338251350630
spellingShingle Qiuhua Duan MM
Yue Feng MM
Lichen Cao MM
Lijun Hu PhD
Jianlin Wang PhD
Fei Sun PhD
Qinghong Meng
Mengyun Zhou MM
Jingping Yu PhD
Haiyan Gao PhD
Efficacy and Safety of Poly (ADP-Ribose) Polymerase Inhibitors in Combination with Chemotherapy for Advanced Breast Cancer: A Systematic Review and Meta-Analysis
Technology in Cancer Research & Treatment
title Efficacy and Safety of Poly (ADP-Ribose) Polymerase Inhibitors in Combination with Chemotherapy for Advanced Breast Cancer: A Systematic Review and Meta-Analysis
title_full Efficacy and Safety of Poly (ADP-Ribose) Polymerase Inhibitors in Combination with Chemotherapy for Advanced Breast Cancer: A Systematic Review and Meta-Analysis
title_fullStr Efficacy and Safety of Poly (ADP-Ribose) Polymerase Inhibitors in Combination with Chemotherapy for Advanced Breast Cancer: A Systematic Review and Meta-Analysis
title_full_unstemmed Efficacy and Safety of Poly (ADP-Ribose) Polymerase Inhibitors in Combination with Chemotherapy for Advanced Breast Cancer: A Systematic Review and Meta-Analysis
title_short Efficacy and Safety of Poly (ADP-Ribose) Polymerase Inhibitors in Combination with Chemotherapy for Advanced Breast Cancer: A Systematic Review and Meta-Analysis
title_sort efficacy and safety of poly adp ribose polymerase inhibitors in combination with chemotherapy for advanced breast cancer a systematic review and meta analysis
url https://doi.org/10.1177/15330338251350630
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