PMID- 34154315 OWN - NLM STAT- MEDLINE DCOM- 20210623 LR - 20210623 IS - 0529-567X (Print) IS - 0529-567X (Linking) VI - 56 IP - 6 DP - 2021 Jun 25 TI - [Analysis of PARP inhibitors induced anemia in advanced and relapsed epithelial ovarian cancer]. PG - 401-407 LID - 10.3760/cma.j.cn112141-20210104-00006 [doi] AB - Objective: To explore the clinical features of poly ADP-ribose polymerase (PARP) inhibitor-related anemia in advanced and relapsed epithelial ovarian cancer (EOC). Methods: Patients diagnosed with advanced or relapsed EOC and treated with PARP inhibitor at National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College between January 2015 to October 2020 were accrued. The data included PARP inhibitors, treatment details, and lab tests before treatment and during treatment were collected and the clinical characteristics of PARP inhibitor-related anemia were analyzed. Results: (1) A total of 98 patients with a median age of 56.5 years old (30-82 years old) were enrolled in this study. All patients were treated with PARP inhibitor (65 cases of olaparib, 17 cases of niraparib, and 16 cases of fluzoparib). The median treatment duration was 37.5 weeks (4-119 weeks). (2) The anemia rate was 40% (39/98), including 5% (5/98) of grade Ⅰ, 14% (14/98) of grade Ⅱ, 11% (11/98) of grade Ⅲ, and 9% (9/98) of grade Ⅳ. Fourteen patients with pre-treatment grade Ⅰ anemia had a higher rate of anemia events than the 80 patients without pre-treatment anemia, 7/14 vs 35% (28/80; chi(2)=4.281, P=0.039). (3) The median anemia occurrence time was 7.0 weeks (1-52 weeks), including 41% (16/39) of anemia cases occurred in 1-4 weeks, 26% (10/39) occurred in 5-8 weeks, 13% (5/39) occurred in 9-12 weeks, 3% (1/39) occurred in 13-16 weeks, 10% (4/39) occurred in 17-20 weeks, 8% (3/39) occurred >/=21 weeks. At the time of the lowest hemoglobulin tested, the median value of mean corpuscular volume (MCV) was 106 fl,which was higher than the up limit of normal range (100 fl), 74% (29/39) of anemia patients had an elevated MCV level; the median value of mean corpuscular hemoglobin (MCH) was 36 pg, 54% (21/39) of anemia patients had an elevated MCH level; the median value of mean corpuscular hemoglobin concentration (MCHC) was 320 g/L, 69% (27/39) of anemia patients had a higher MCHC level; 92% (36/39) of anemia patients had a normal level of serum iron; 79% (31/39) of anemia patients had a normal level of transferrin. 74% (29/39) of the anemia patients were macrocytic orthochromatic anemia. (4) Among the 39 patients with anemia, 20 patients (51%, 20/39) withhold the treatment of PARP inhibitor due to grade Ⅲ or Ⅳ anemia, including 10 patients (50%, 10/20) who resumed the PARP inhibitor treatment by suppling iron, folate, and vitamin B(12). The median stopping time of PARP inhibitor was 5.5 weeks (2-10 weeks), while the other 10 patients terminated the PARP inhibitor treatment for not recovering from severe anemia. Conclusions: One of the common adverse effects of PARP inhibitors is anemia, which mostly happened in the first 3 months of treatment. In the treatment of EOC, PARP inhibitor-related anemia mainly manifest as macrocytic orthochromatic anemia, and most patients with normal serum iron and transferrin. FAU - Zeng, J AU - Zeng J AD - Department of Gynecological Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China. FAU - Li, N AU - Li N AD - Department of Gynecological Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China. FAU - Yuan, G W AU - Yuan GW AD - Department of Gynecological Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China. FAU - Sun, Y C AU - Sun YC AD - Department of Gynecological Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China. FAU - Zhang, R AU - Zhang R AD - Department of Gynecological Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China. FAU - Li, X G AU - Li XG AD - Department of Gynecological Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China. FAU - Zuo, J AU - Zuo J AD - Department of Gynecological Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China. FAU - Li, N AU - Li N AD - Department of Gynecological Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China. FAU - Wu, L Y AU - Wu LY AD - Department of Gynecological Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China. LA - chi GR - LC2020A10/Beijing Hope Run Special Fund of Cancer Foundation of China/ GR - Y‑HR2019‑0306/Beijing Xisike Clinical Oncology Research Foundation Xisike-Hengrui Oncology Research Fund/ PT - Journal Article PL - China TA - Zhonghua Fu Chan Ke Za Zhi JT - Zhonghua fu chan ke za zhi JID - 16210370R RN - 0 (Poly(ADP-ribose) Polymerase Inhibitors) SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - *Anemia/chemically induced/epidemiology MH - Carcinoma, Ovarian Epithelial/drug therapy MH - Female MH - Humans MH - Middle Aged MH - Neoplasm Recurrence, Local/drug therapy MH - *Ovarian Neoplasms/drug therapy MH - Poly(ADP-ribose) Polymerase Inhibitors/adverse effects EDAT- 2021/06/23 06:00 MHDA- 2021/06/24 06:00 CRDT- 2021/06/22 03:54 PHST- 2021/06/22 03:54 [entrez] PHST- 2021/06/23 06:00 [pubmed] PHST- 2021/06/24 06:00 [medline] AID - 10.3760/cma.j.cn112141-20210104-00006 [doi] PST - ppublish SO - Zhonghua Fu Chan Ke Za Zhi. 2021 Jun 25;56(6):401-407. doi: 10.3760/cma.j.cn112141-20210104-00006.