Systematic review and meta-analysis of PARP inhibitor maintenance after first-line chemotherapy for advanced-stage epithelial ovarian cancer

Systematic review and meta-analysis of 7 randomized clinical trials with 4013 patients with advanced-stage epithelial ovarian cancer (responding to first-line platinum-based chemotherapy) evaluated PARP-inhibitor maintenance. PARP inhibitor maintenance was associated with improved progression-free survival in the overall population (HR 0.57; 95% CI 0.46-0.70) and in all molecular subgroups except tha homologous recombination proficient subgroup. PFS benefits were consistent across surgical timing, chemotherapy responses, and residual disease. In no molecular subgroup PARP inibitor maintenance was associated with statistical significant overall survival benefit. High-grade adverse events were more common in the PARP inhibitor group. The authors conclude that these results suggest that decisions on PARP inhibitor maintenance should be individualized.