奥拉帕利维持治疗乳腺癌易感基因突变铂敏感卵巢癌疗效的meta分析  

Efficacy of olaparib maintenance therapy for platinum-sensitive ovarian cancer with breast cancer susceptibility gene mutation:a meta analysis

作　　者：寇利秋 谢晓露 陈秀 聂丹 李亚玲 KOU Li-qiu;XIE Xiao-lu;CHEN Xiu;NIE Dan;LI Ya-ling(Department of Pharmacy,Affiliated Hospital of Southwest Medical University,Sichuan Luzhou 646000,China;Department of Clinical Pharmacy,School of Pharmacy,Southwest Medical University,Sichuan Luzhou 646000,China;Department of Gynecology,Affiliated Hospital of Southwest Medical University,Sichuan Luzhou 646000,China)

机构地区：[1]西南医科大学附属医院药学部,四川泸州646000 [2]西南医科大学药学院,四川泸州646000 [3]西南医科大学附属医院妇科,四川泸州646000

出　　处：《临床药物治疗杂志》2023年第3期50-55,共6页Clinical Medication Journal

基　　金：四川医院管理和发展研究中心项目(SCYG2019-04);四川医事卫生法治研究中心课题(YF19-Y12)。

摘　　要：目的 系统评价奥拉帕利维持治疗乳腺癌易感基因(BRCA)突变铂敏感卵巢癌的临床疗效及安全性。方法 计算机检索PubMed、Cochrane、Web of Science、中国知网、万方数据库、维普数据库等,收集奥拉帕利(观察组)与安慰剂(对照组)治疗BRCA突变铂敏感卵巢癌的随机对照试验。应用RevMan5.3软件进行meta分析。结果 最终纳入5篇文献。meta分析结果显示,观察组患者的中位无进展生存期(HR=0.35,95%CI:0.22~0.56,P<0.001)、总生存期(HR=0.77,95%CI:0.62~0.95,P<0.05)均明显长于对照组,差异有统计学意义。观察组的关节痛、腹痛、便秘、鼻咽炎等不良反应发生率与对照组差异无统计学意义(P>0.05);而头痛、消化不良、发热等发生率高于对照组,差异有统计学意义(P<0.05),但是这些不良反应的程度较轻,多为1~2级反应,大多数患者通过对症治疗和(或)奥拉帕利剂量调整后是可控的,只有极少数患者需要停用奥拉帕利。结论 奥拉帕利维持治疗BRCA突变铂敏感卵巢癌患者中疗效显著,安全可控,值得向临床推荐。Objective To systematically evaluate the clinical efficacy and safety of olaparib maintenance treatment for platinum-sensitive ovarian cancer with breast cancer susceptibility gene(BRCA)mutations.Methods The database of PubMed,Cochrane,Web of Science,CNKI,Wanfang,and VIP were searched to collect randomized controlled trials of olaparib(the observation group)versus placebo(the control group)for the treatment of platinum-sensitive ovarian cancer with BRCA mutation.RevMan 5.3 software was applied for meta-analysis.Results Five studies were finally included.According to the results of the meta-analysis,the median progression-free survival(HR=0.35,95%CI:0.22 to 0.56,P<0.00001)and total survival(HR=0.77,95%CI:0.62 to 0.95,P=0.02)of the patients in the observation group were significantly longer than those in the control group,and the difference was statistically significant.The incidence of adverse reactions such as arthralgia,abdominal pain,constipation in the observation group was not statistically significant(P>0.05)compared with the control group;However,the incidence of headache,dyspepsia,fever and so on was more frequent than that in the control group,and the differences was statistically significant(P<0.05).However,the degree of these adverse reactions was mild,mostly grade 1 to 2 responses,most patients can be controlled by symptomatic treatment and(or)olaparib dose adjustment,and only a minimal number of patients require discontinuation of stop olaparib.Conclusion Olaparib maintenance treatment in patients with BRCA-mutated platinum-sensitive ovarian cancer is effective,safe and controllable,and it is worth to be recommended for clinical use.

关 键 词：奥拉帕利 BRCA突变 铂敏感卵巢癌 META分析 

分 类 号：R979.19[医药卫生—药品] R737.31[医药卫生—药学]