PMID- 29942664
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210126
IS  - 2059-7029 (Print)
IS  - 2059-7029 (Electronic)
IS  - 2059-7029 (Linking)
VI  - 3
IP  - 4
DP  - 2018
TI  - Single-agent PARP inhibitors for the treatment of patients with BRCA-mutated 
      HER2-negative metastatic breast cancer: a systematic review and meta-analysis.
PG  - e000361
LID - 10.1136/esmoopen-2018-000361 [doi]
LID - e000361
AB  - Single-agent poly (ADP-ribose) polymerase (PARP) inhibitors (PARPi) have been 
      approved as the first targeted therapy available for patients with BRCA-mutated 
      HER2-negative metastatic breast cancer. This meta-analysis aimed to better 
      evaluate activity, efficacy and safety of single-agent PARPi in this population. 
      A systematic search of Medline, Embase and conference proceedings up to 31 
      January 2018 was conducted to identify randomised controlled trials (RCTs) 
      investigating single-agent PARPi versus monochemotherapy in patients with 
      BRCA-mutated HER2-negative metastatic breast cancer. Using the random-effect 
      model, we calculated summary risk estimates (pooled HR and OR with 95% CI) for 
      progression-free survival (PFS), overall survival (OS), objective response rate 
      (ORR), any grade and grade 3-4 adverse events (AEs), treatment discontinuation 
      rate and time to deterioration in quality of life (QoL). Two RCTs (n=733) were 
      included. As compared with monochemotherapy, single-agent PARPi significantly 
      improved PFS (HR 0.56(95% CI 0.45 to 0.70)) and ORR (OR 4.15 (95% CI 2.82 to 
      6.10)), with no difference in OS (HR 0.82 (95% CI 0.64 to 1.05)). Single-agent 
      PARPi significantly increased risk of anaemia and any grade headache, but reduced 
      risk of neutropenia and any grade palmar-plantar erythrodysesthesia syndrome as 
      compared with monochemotherapy. No significant differences in other AEs and 
      treatment discontinuation rate were observed. Patients treated with PARPi 
      experienced a significant delayed time to QoL deterioration (HR 0.40 (95% CI 0.29 
      to 0.54)). Single-agent PARPi showed to be an effective, well tolerated and 
      useful treatment in maintaining QoL of patients with BRCA-mutated HER2-negative 
      metastatic breast cancer.
FAU - Poggio, Francesca
AU  - Poggio F
AD  - Department of Medical Oncology, Institut Jules Bordet, Universite Libre de 
      Bruxelles (U.L.B.), Bruxelles, Belgium.
AD  - Department of Medical Oncology, Oncologia Medica 2, Ospedale Policlinico San 
      Martino, Genova, Italy.
FAU - Bruzzone, Marco
AU  - Bruzzone M
AD  - Unit of Clinical Epidemiology, Ospedale Policlinico San Martino, Genova, Italy.
FAU - Ceppi, Marcello
AU  - Ceppi M
AD  - Unit of Clinical Epidemiology, Ospedale Policlinico San Martino, Genova, Italy.
FAU - Conte, Benedetta
AU  - Conte B
AD  - Department of Medical Oncology, Oncologia Medica 2, Ospedale Policlinico San 
      Martino, Genova, Italy.
FAU - Martel, Samuel
AU  - Martel S
AD  - Department of Hemato-Oncology, CISSS Monteregie-Centre/Hopital Charles-Le Moyne, 
      centre affilie de l'Universite de Sherbrooke, Quebec, Canada.
FAU - Maurer, Christian
AU  - Maurer C
AD  - Department I of Internal Medicine, Center of Integrated Oncology Cologne Bonn, 
      University of Cologne, Cologne, Germany.
FAU - Tagliamento, Marco
AU  - Tagliamento M
AD  - Department of Medical Oncology, Oncologia Medica 2, Ospedale Policlinico San 
      Martino, Genova, Italy.
FAU - Viglietti, Giulia
AU  - Viglietti G
AD  - Breast Cancer Translational Research Laboratory, Institute Jules Bordet, 
      Universite Libre de Bruxelles (U.L.B.), Bruxelles, Belgium.
FAU - Del Mastro, Lucia
AU  - Del Mastro L
AD  - Department of Medical Oncology, U.O. Sviluppo Terapie Innovative, Ospedale 
      Policlinico San Martino, Department of Internal Medicine and Medical Specialties 
      (DIMI), University of Genova, Genova, Italy.
FAU - de Azambuja, Evandro
AU  - de Azambuja E
AD  - Department of Medical Oncology, Institut Jules Bordet, Universite Libre de 
      Bruxelles (U.L.B.), Bruxelles, Belgium.
FAU - Lambertini, Matteo
AU  - Lambertini M
AUID- ORCID: 0000-0003-1797-5296
AD  - Department of Medical Oncology, Institut Jules Bordet, Universite Libre de 
      Bruxelles (U.L.B.), Bruxelles, Belgium.
AD  - Breast Cancer Translational Research Laboratory, Institute Jules Bordet, 
      Universite Libre de Bruxelles (U.L.B.), Bruxelles, Belgium.
LA  - eng
PT  - Journal Article
DEP - 20180620
PL  - England
TA  - ESMO Open
JT  - ESMO open
JID - 101690685
PMC - PMC6012556
OTO - NOTNLM
OT  - BRCA mutation
OT  - PARP inhibitors
OT  - chemotherapy
OT  - metastatic breast cancer
COIS- Competing interests: LDM received personal fees from Novartis Pharma AG, 
      Roche-Genentech, Ipsen, Astrazeneca, Takeda, Eli Lilly outside the submitted 
      work. EdA received honoraria from Roche-Genentech, research grant from 
      Roche-Genentech (to the institution) and travel grants from Roche-Genentech and 
      GlaxoSmithKline outside the submitted work. ML served as a consultant for Teva 
      outside the submitted work.
EDAT- 2018/06/27 06:00
MHDA- 2018/06/27 06:01
PMCR- 2018/06/20
CRDT- 2018/06/27 06:00
PHST- 2018/03/20 00:00 [received]
PHST- 2018/03/29 00:00 [accepted]
PHST- 2018/06/27 06:00 [entrez]
PHST- 2018/06/27 06:00 [pubmed]
PHST- 2018/06/27 06:01 [medline]
PHST- 2018/06/20 00:00 [pmc-release]
AID - S2059-7029(20)32303-6 [pii]
AID - esmoopen-2018-000361 [pii]
AID - 10.1136/esmoopen-2018-000361 [doi]
PST - epublish
SO  - ESMO Open. 2018 Jun 20;3(4):e000361. doi: 10.1136/esmoopen-2018-000361. 
      eCollection 2018.