Research Paper Volume 13, Issue 1 pp 450—459
Comparative efficacy, safety, and acceptability of single-agent poly (ADP-ribose) polymerase (PARP) inhibitors in BRCA-mutated HER2-negative metastatic or advanced breast cancer: a network meta-analysis
- 1 Chongqing Municipal Center for Disease Control and Prevention, Chongqing, P.R. China
- 2 Department of Breast and Thyroid Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, P.R. China
Received: April 16, 2020 Accepted: October 5, 2020 Published: November 30, 2020https://doi.org/10.18632/aging.202152
How to Cite
Copyright: © 2020 Wang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Breast cancer is the most commonly diagnosed cancer and is the leading cause of cancer death in women worldwide. Both talazoparib and olaparib are approved by the US Food and Drug Administration for treating BRCA (breast cancer 1, early onset)-mutated HER2 (human epidermal growth factor receptor 2)-negative metastatic or advanced breast cancer. However, the optimal choice of first-line treatment has not been determined.
Objective: To compare the efficacy, safety, and acceptability of single-agent poly (ADP-ribose) polymerase (PARP) inhibitors for patients with BRCA-mutated HER2-negative metastatic or advanced breast cancer.
Results: We included two trials comprising 733 participants. Compared with talazoparib, olaparib was not associated with improved PFS (HR = 1.08, 95% CrI = 0.34–3.45) or OS (HR = 1.18, 95% CrI = 0.61–2.31). Compared with talazoparib, olaparib was associated with non-significantly improved ORR (OR = 0.83, 95% CrI = 0.05–12.64). Regarding safety, olaparib had reduced risk for both grade 3–4 anemia (OR = 0.34, 95% CrI = 0.003–34.94) and any-grade anemia (OR = 0.37, 95% CrI = 0.02–6.81) compared with talazoparib. Olaparib also showed a low risk for grade 3–4 neutropenia (OR = 0.57, 95% CrI = 0.06–5.75) compared with talazoparib. Both talazoparib and olaparib were not associated with high risk of treatment discontinuation (OR = 0.95, 95% CrI = 0.21–4.47). Regarding time to QoL deterioration, olaparib was associated with short time to clinically meaningful QoL deterioration (HR = 1.16, 95% CrI = 0.19–7.17) compared to talazoparib.
Conclusion: Both talazoparib and olaparib have similar efficacy, safety, and acceptability in patients with BRCA-mutated HER2-negative metastatic or advanced breast cancer. Well-designed head-to-head randomized controlled trials with large samples are suggested to determine the optimal treatment choice.
Methods: We performed a systematic review and network meta-analysis. We performed a systematic search of Web of Science, Embase, PubMed, Medline,
BC: breast cancer; HER-2: human epidermal growth factor receptor-2; ER: estrogen receptor; PR: progesterone receptor; gBRCA: germline BRCA; TNBC: triple-negative breast cancer.