Haematologic toxicities with PARP inhibitors in cancer patients: an up-to-date meta-analysis of 29 randomized...

Poly ADP-ribose polymerase (PARP) inhibitors have emerged as one of the most exciting new treatments for patients with certain types of cancer. Haematologic toxicities are common adverse events (AEs) for all PARP inhibitors. We conducted a meta-analysis to fully investigate the haematologic toxicities of PARP inhibitors in cancer patients.

PubMed/Medline and Embase were searched for articles published till September 2020. The relevant randomized controlled trials (RCTs) in cancer patients treated with PARP inhibitors were retrieved, and the systematic evaluation was performed.

Twenty-nine RCTs and 9247 patients were included. The current meta-analysis suggests that the use of PARP inhibitors significantly increases the risk of all-grade anaemia (RR, 2.32; 95% CI, 1.78-3.01; p < 0.00001), neutropenia (RR, 1.69; 95% CI, 1.38-2.07; p < 0.00001) and thrombocytopenia (RR, 2.54; 95% CI, 1.87-3.45; p < 0.00001). The use of these agents also significantly increased the risk of high-grade anaemia (RR, 3.06; 95% CI, 2.11-4.43; p < 0.00001), neutropenia (RR, 1.66; 95% CI, 1.33-2.07; p < 0.00001) and thrombocytopenia (RR, 2.76; 95% CI, 1.83-4.16; p < 0.00001). Anaemia was the most common haematologic toxicity, and all the five included PARP inhibitors were associated with a significant increased risk of anaemia. Combination treatment may reduce the risk of anaemia and thrombocytopenia compared to those receiving PARP inhibitor monotherapy.

The available data suggested that the use of PARP inhibitors was associated with a significantly increased risk of haematologic toxicities.