PARP inhibitor maintenance therapy improved progression free survival in newly diagnosed advanced ovarian cancer but not survival.
PARP Inhibitors in Maintenance Therapy
In this meta-analysis, investigators evaluated poly adenosine diphosphate ribose polymerase inhibitors as maintenance therapy for patients with newly diagnosed advanced ovarian cancer. The review pooled seven randomized controlled trials comprising 11 studies and 3,220 patients and used both pairwise meta-analysis and Bayesian network meta-analysis to compare outcomes. Progression free survival and adverse events were the primary end points, providing an integrated view of efficacy and safety across the PARP inhibitor class in this setting.
Progression Free Survival Gains Across Genomic Subgroups
Across the pooled population, maintenance treatment with PARP inhibitors significantly improved progression free survival compared with non-PARP inhibitor regimens. Subgroup analyses showed consistent progression free survival benefit in patients with BRCA mutations, BRCA wild type tumors, homologous recombination deficiency and homologous recombination proficiency. However, the meta-analysis did not demonstrate an overall survival advantage with PARP inhibitors in the overall cohort or in the homologous recombination deficiency subgroup. Within the network comparison, senaparib achieved superior progression free survival efficacy compared with veliparib and niraparib, suggesting potential differences between individual agents within the class.
Balancing Efficacy and Safety in Clinical Practice
The improved disease control seen with PARP inhibitor maintenance therapy came at the cost of higher toxicity. Treatment with PARP inhibitors was associated with a significantly increased incidence of grade three or higher adverse events when compared with non-PARP inhibitor regimens. For clinicians, these findings highlight the need to balance progression free survival gains against the risk of serious toxicity when selecting maintenance strategies for newly diagnosed advanced ovarian cancer. The results from this meta-analysis support the role of PARP inhibitors as an effective maintenance option while underlining the importance of careful patient selection, monitoring and shared decision making in routine practice.
Reference: Zhang W et al. Unveiling the power of PARP inhibitors: a meta-analysis on newly diagnosed advanced ovarian cancer maintenance therapy. Expert Rev Anticancer Ther. 2025;doi:10.1080/14737140.2025.2591327.
