Abstract
Ovarian cancer is the 5th most common cancer in developed countries. Recently, some oral poly (ADP-ribose) polymerase (PARP) inhibitors were approved in the US for treatment of ovarian cancer. Comparison of the efficacy and safety of these agents may be of value to healthcare providers and US payers. A systematic literature search of PubMed and ClinicalTrials.gov was conducted to identify phase II and phase III clinical trials (2010-2017) that evaluated the efficacy and safety of ovarian cancer treatment regimens. Treatment regimens included olaparib, rucaparib, and niraparib. Patient characteristics, and efficacy and safety data were extracted and reviewed by two independent researchers. Descriptive statistics were used to compare the results of the clinical trials. Thirteen clinical trials of PARP inhibitor treatment regimens were identified (olaparib=9, rucaparib=3, niraparib=1). Of the 1,235 patients in the olaparib trials (mean ages: 54-74 years), 535 (43%) had BRCA1 mutations and 195 (16%) had BRCA2 mutations. Of the 834 patients in the rucaparib trials (mean ages: 52-65 years), 194 (23%) had BRCA1 mutations and 116 (14%) had BRCA2 mutations. The 1 niraparib trial, consisting of two treatment populations (with vs. without BRCA1/2 mutations) from which data were extracted independently, included 553 patients (mean ages: 57-63 years), of which 128 (23%) had BRCA1 mutations and 69 (12%) had BRCA2 mutations. For trials of olaparib, rucaparib, and niraparib, the median months of progression-free survival (PFS) ranged from 5.8 – 19.1 months, 5.2 – 16.6 months, and 9.3 – 21.0 months, respectively. Grade ≥3 adverse events occurred in approximately 65%, 56%, and 74% of patients treated with olaparib, rucaparib, or niraparib, respectively. For most treatment regimens, a PFS of at least 5 months was observed. Further study is needed to determine the comparative efficacy of these novel PARP inhibitor treatments for patients with ovarian cancer in the real-world settings.
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