PARP抑制剂与贝伐珠单抗治疗铂敏感复发性卵巢癌的网状Meta分析  

Reticular meta-analysis of PARP inhibitors versus Bevacizumab in Platinum-sensitive recurrent Ovarian Cancer

作　　者：肖天龄 李娜[2] 王娅丹 尚美芳 闫佳乐 Xiao Tianling;Li Na;Wang Yadan;Shang Meifang;Yan Jiale(Central Clinical College,Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014040,China;Department of Gynecology,Baotou Central Hospital,Baotou 014040,China)

机构地区：[1]内蒙古科技大学包头医学院中心临床学院,内蒙古包头014040 [2]内蒙古包头市中心医院妇科,内蒙古包头014040

出　　处：《实用妇科内分泌电子杂志》2022年第4期24-29,共6页Electronic Journal of Practical Gynecological Endocrinology

摘　　要：目的通过网状Meta分析比较聚腺苷酸二磷酸核糖转移酶(PARP)抑制剂与贝伐珠单抗治疗铂敏感复发性卵巢癌的疗效,为铂敏感复发性卵巢癌患者提供最有效的维持治疗策略。方法计算机检索中国知网、万方数据库、维普数据库、中国生物医学数据库、Pubmed、Web of Science、Embase及Cochrane Library等中英文数据库,检索时限设置为数据库建库日至2021年9月。检索关于PARP抑制剂与贝伐珠单抗治疗铂敏感复发性卵巢癌的随机对照试验。将筛选出的文献按照《Cochrane评价手册》提供的评估偏倚风险工具对纳入的文献进行质量评价及相关数据的提取,并采用R3.5.1统计软件进行数据分析。结果在无进展生存期(PFS)方面,与贝伐珠单抗相比,PARP抑制剂延长了PFS(HR=0.64,95%CI0.50,0.82);BRCAm人群中,与贝伐珠单抗相比,PARP抑制剂更加显著改善PFS(HR=0.50,95%CI0.33,0.74);BRCAwt人群中,PARP抑制剂未表现出明显优势(HR=0.82,95%CI0.65,1.03)。然而,根据优选概率排名曲线(SUCRA)分析,提示在BRCAwt人群PARP抑制剂为最有效治疗策略。结论对于铂敏感复发性卵巢癌患者,无论乳腺癌易感基因(BRCA)状态,与贝伐珠单抗相比,PARP抑制剂治疗组疗效更好,应作为铂敏感复发性卵巢癌患者首选。Objective To efficacy of poly adenylate diphosphate ribotransferase(PARP)inhibitors and bevacizumab in the treatment of platinum-sensitive recxirrent ovarian cancer was compared in a mesh meta-analysis,providing the most effective maintenance therapy strategy for patients with platinum-sensitive recurrent ovarian cancer.Methods Chinese and English databases including CNKI,Wanfang,VIP,CBM,Pubmed,Web of Science,Embase and Cochrane Library were searched by computer.The retrieval time limit is set to September 2021 from the database construction date.Randomized controlled trials(RCTS)of PARP inhibitors or bevacizumab in platinum-sensitive recurrent ovarian cancer were searched strictly following the"keywords+free words"and PICOS principles.The selected literatures were evaluated for quality and extracted related data according to the risk assessment tool of bias provided by The Cochrane Review Manual.Statistical software R3.5.1 statistical software was used for data analysis.Results In terms of progression-free survival(PFS),PARP inhibitors extended PFS compared with bevacizumab(HR=0.64,95%CI0.50,0.82);In BRCAm,PARP inhibitors significantly improved PFS compared with bevacizumab(HR=0.50,95%CI0.33,0.74);In BRCAwt,PARP inhibitors showed no significant advantage(HR=0.82,95%CI 0.65,1.03).However,SUCRA analysis suggested that PARP inhibitors were the most effective treatment strategy in the BRCAwt population.Conclusion For patients with platinum-sensitive recurrent ovarian cancer,regardless of BRCA status,PARP inhibitor treatment group has better efficacy compared with bevacizumab,and should be the first choice for patients with platinum-sensitive recurrent ovarian cancer.

关 键 词：铂敏感复发性卵巢癌 聚腺苷酸二磷酸核糖转移酶抑制剂 贝伐珠单抗 乳腺癌易感基因检测 

分 类 号：R737.31[医药卫生—肿瘤]