Olaparib As Therapy For Metastatic-Castration Resistant Prostate Cancer : Systematic Review And Meta Analysis

I Made Rian Putra Gunawan, Fauna Herawati, Aguslina Kirtishanti

Abstract


Prostate cancer is the second most prevalent cancer in men with approximately 1.4 million men worldwide. The main therapy for prostate cancer is androgen deprivation therapy (ADT), but patients who have received ADT may experience a condition of castration resistant prostate cancer (CRPC). More than 84% of patients have metastasized when diagnosed with CRPC (mCRPC) and median survival about 36 months. The Food & Drugs Association (FDA) has approved a new therapy for mCRPC patients, an example is olaparib. The purpose of this systematic review and meta analysis is to assess effectiveness (overall survival) and safety of olaparib in mCRPC. This research is using randomized control trials (RCT) article. The literature search process was carried out using the PubMed database. The quality of inclusion was assessed using the Critical Appraisal Skill Program (CASP) checklist and journal reputation. The results of the meta-analysis on the effectiveness of olaparib has showed that there was no significant difference in the patient's overall survival rate (RR=0. 81; 95% CI=0.58-1.13). The results of the meta analysis on the safety level of olaparib has showed a significant difference, seen from the side effects such as anemia (RR=3.47; 95% CI=2.59-4.65), nausea (RR=2.05; 95% CI=1.62-2.60) and fatigue (RR=1.32; 95% CI=1.10-1.59). The conclusion is olaparib as mCRPC therapy does not show significant effectiveness in improving overall survival in mCRPC. In addition, the low safety level of olaparib in mCRPC patients were seen from side effects such as anemia, nausea and fatigue

Save to Mendeley


Keywords


PARP inhibitors; olaparib; overall survival; safety

Full Text:

PDF

References


Antonarakis, E.S., Gomella, L.G. and Petrylak, D.P., 2020, When and How to Use PARP Inhibitors in Prostate Cancer: A Systematic Review of the Literature with an Update on On Going Trials, European Urology Oncology, 3(5):594611, doi: 10.1016/j.euo.2020.07.005.

Bang, Y.J., Xu, R.H., Chin, K., Lee, K.W., Park, S.H., Rha, S.Y. et al., 2017, Olaparib in Combination with Paclitaxel in Patients with Advanced Gastric Cancer Who Have Progressed Following First-Line Therapy (GOLD): A Double-blind, Randomised, Placebo-Controlled, Phase 3 Trial, The Lancet Oncology, 18(12):16371651, doi: 10.1016/S1470-2045(17)30682-4.

de Bono, J., Mateo, J., Fizazi, K., Saad, F., Shore, N., Sandhu, S. et al., 2020, Olaparib for Metastatic Castration-Resistant Prostate Cancer, New England Journal of Medicine, 382(22): 20912102, doi: 10.1056/nejmoa1911440.

Clarke, N., Wiechno, P., Alekseev, B., Sala, N., Jones, R., Kocak, I. et al., 2018, Olaparib Combined with Abiraterone in Patients with Metastatic Castration-Resistant Prostate Cancer: A Randomised, Double-blind, Placebo-Controlled, Phase 2 Trial, The Lancet Oncology, 19(7):975986, doi: 10.1016/S1470 2045(18)30365-6.

Dai, D., Han, S., Li, L., Guo, Y., Wei, Y., Jin, H. et al., 2018, Anemia is Associated with Poor Outcomes of Metastatic Castration-Resistant Prostate Cancer, A Systematic Review and Meta-Analysis, American Journal of Translational Research, 10(12):38773886.

Eakin, C.M., Norton, T.J., Monk, B.J. and Chase, D.M., 2020, Management of Nausea and Vomiting from Poly(ADP-Ribose) Polymerase Inhibitor Therapy for Advanced Ovarian Cancer, Gynecologic Oncology, 159(2):581587, doi: 10.1016/j.ygyno. 2020.08.016.

Guo, X.X., Wu, H.L., Shi, H.Y., Su, L. and Zhang, X., 2018, The Efficacy and Safety of Olaparib in the Treatment of Cancers: A Meta-Analysis of Randomized Controlled Trials, Cancer Management and Research, 10:25532562, doi: 10.2147/ CMAR.S169558.

Hatano, K. and Nonomura, N., 2023, Systemic Therapies for Metastatic Castration-Resistant Prostate Cancer: An Updated Review, The World Journal of Mens Health, 41, doi: 10.5534/wjmh.220200.

Hussain, M., Mateo, J., Fizazi, K., Saad, F., Shore, N., Sandhu, S. et al., 2020, Survival with Olaparib in Metastatic Castration Resistant Prostate Cancer, New England Journal of Medicine, 383(24):23452357. doi: 10.1056/nejmoa2022485.

Iannantuono, G.M., Chandran, E., Floudas, C.S., Wosoba, H.C., Butera, G., Roselli, M. et al., 2023, Efficacy and Safety of PARP Inhibitors in Metastatic Castration-Resistant Prostate Cancer: A Systematic Review and Meta-Analysis of Clinical Trials, Cancer Treatment Reviews, 120(June):102623, doi: 10.1016/j.ctrv.2023.102623.

Keisner, S.V., 2022, Rucaparib and Olaparib for the Treatment of Prostate Cancer: A Clinicians Guide to Choice of Therapy, Journal of Oncology Pharmacy Practice, 28(7):16241633, doi: 10.1177/10781552221094308.

Kim, J.W., McKay, R.R., Radke, M.R., Zhao, S., Taplin, M.E., Davis, N.B. et al., 2023, Randomized Trial of Olaparib With or Without Cediranib for Metastatic Castration-Resistant Prostate Cancer: The Results from National Cancer Institute 9984, Journal of Clinical Oncology, 41(4):871880, doi: 10.1200/ JCO.21.02947.

Kirby, M., Hirst, C. and Crawford, E.D., 2011, Characterising The Castration-Resistant Prostate Cancer Population: A Systematic Review, International Journal of Clinical Practice, 65(11):11801192, doi: 10.1111/j.1742-1241.2011.02799.x.

Levee, A., Lin, C.Y., Posadas, E., Figlin, R., Bhowmick, N.A., Di Vizio, D., et al., 2021, Clinical Utility of Olaparib in The Treatment of Metastatic Castration-Resistant Prostate Cancer: A Review of Current Evidence and Patient Selection, OncoTargets and Therapy, 14(September):48194832, doi: 10.2147/OTT.S315170.

Li, J. and Zhang, Z., 2021, Risk of Fatigue with PARP Inhibitors in Cancer Patients: A Systematic Review and Meta-Analysis of 29 Phase II/III Randomized Controlled Trials, Journal of Chemotherapy, 33(7):452461, doi: 10.1080/1120009X.2021. 1884797.

Luo, Z., Zhu, B., Xu, H., Chen, L., Song, X., Wang, Y. et al., 2023, Efficacy and Safety of Olaparib Combined with Abiraterone in Patients with Metastatic Castration-Resistant Prostate Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials, Frontiers in Oncology, 13(October):110, doi: 10.3389/fonc.2023.1265276.

Maiorano, B.A., Giorgi, U.D., Verzoni, E., Maiello, E., Procopio, G., Conteduca, V. et al., 2023, Hematological Toxicity of PARP Inhibitors in Metastatic Prostate Cancer Patients with Mutations of BRCA or HRR Genes: A Systematic Review and Safety Meta-analysis, Targeted Oncology, (0123456789), doi: 10.1007/s11523-023-01016-x.

Mottet, N., van den Bergh, R.C.N., Briers, E., van den Broeck, T., Cumberbatch, M.G., De Santis, M. et al., 2021, AU-EANM ESTRO-ESUR-SIOG Guidelines on Prostate Cancer-2020 Update. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent, European Urolology, 79(2):243-262, doi: 10.1016/j.eururo.2020.09.042. Epub 2020 Nov 7. PMID: 33172724.

Pujade-Lauraine, E., Ledermann, J.A., Selle, F., Gebski, V., Penson, R.T., Oza, A.M. et al., 2017, Olaparib Tablets as Maintenance Therapy in Patients With Platinum-Sensitive, Relapsed Ovarian Cancer and a BRCA1/2 Mutation (SOLO2/ENGOT-Ov21): A Double-Blind, Randomised, Placebo-Controlled, Phase 3 Trial, The Lancet Oncology, 18(9):12741284, doi: 10.1016/S1470-2045(17)30469-2.

Ratta, R., Guida, A., Scotte, F., Neuzillet, Y., Teillet, A.B., Lebret, T. et al., 2020, PARP Inhibitors as a New Therapeutic Option in Metastatic Prostate Cancer: A Systematic Review, Prostate Cancer and Prostatic Diseases, 23(4):549560, doi: 10.1038/s41391-020-0233-3.

Robson, M., Im, S.A., Senkus, E., Xu, B., Domchek, S.M., Masuda, N. et al., 2017, Olaparib for Metastatic Breast Cancer in Patients With A Germline BRCA Mutation, New England Journal of Medicine, 377(6):523533, doi: 10.1056/ nejmoa1706450.

Roubaud, G., Ozguroglu, M., Penel, N., Matsubara, N., Mehra, N., Kolinsky, M.P. et al., 2022, Olaparib Tolerability and Common Adverse-Event Management in Patients With Metastatic Castration-Resistant Prostate Cancer: Further Analyses from the PROfound Study, European Journal of Cancer, 170(May):7384, doi: 10.1016/j.ejca.2022.04.016.

Ruiz-Schutz, V.C., Gomes, L.M., Mariano, R.C., Almeida, D.V.P., Pimenta, J.M., Molin, G.Z.D. et al., 2019, Risk of Fatigue and Anemia in Patients With Advanced Cancer Treated With Olaparib: A Meta-Analysis of Randomized Controlled Trials, Critical Reviews in Oncology/Hematology, 141:163173, doi: 10.1016/j.critrevonc.2019.06.012.

Seruga, B., Ocana, A. and Tannock, I.F., 2011, Drug Resistance in Metastatic Castration-Resistant Prostate Cancer, Nature Reviews Clinical Oncology, 8(1):1223, doi: 10.1038/nrclinonc. 2010.136.

Sung, H., Ferlay, J., Siegel, R.L., Laversanne, M., Soerjomataram, I., Jemal, A. et al., 2021, Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries, CA: A Cancer Journal for Clinicians, 71(3):209249, doi: 10.3322/ caac.21660.

Teyssonneau, D., Margot, H., Cabart, M., Anonnay, M., Sargos, P., Vuong, N.S. et al., 2021, Prostate Cancer and PARP Inhibitors: Progress and Challenges, Journal of Hematology and Oncology, BioMed Central, 14(1):119, doi: 10.1186/ s13045-021-01061-x.

Warli, S.M., Velaro, A.J., Firsty, N.N. and Tala, Z.Z., 2023, Addition of Olaparib to the New Hormonal Agent Regimen for Metastatic Castration-Resistant Prostate Cancer: A Systematic Review and Meta-Analysis, World Journal of Oncology, 14(6):518528. doi: 10.14740/wjon1685.

Wu, K., Liang, J., Shao, Y., Xiong, S., Feng, S. and Li, X., 2021, Evaluation of the Efficacy of PARP Inhibitors in Metastatic Castration-Resistant Prostate Cancer: A Systematic Review and Meta-Analysis, Frontiers in Pharmacology, 12(December):1 10, doi: 10.3389/fphar.2021.777663.




DOI: https://doi.org/10.33508/jfst.v11i1.5284