Incidence of grade 3-4 adverse events, dose reduction and treatment discontinuation in castration-resistant prostate cancer patients receiving PARP inhibitors: a meta-analysis.

PARP inhibitors (PARPi) have recently emerged as a new treatment option for several solid tumors, including metastatic castration-resistant prostate cancer (mCRPC). However, several grade 3-4 adverse events have been reported during PARPi administration, leading to limitations in treatment adherence.

Herein, we conducted a meta-analysis aimed at analyzing the incidence rate of commonly reported grade 3-4 adverse events, dose reduction and treatment discontinuation in mCRPC patients treated with PARPi monotherapy.

Incidence rate with 95% confidence intervals (CIs) of grade 3-4 toxicities, dose reduction and treatment discontinuation were calculated. Six trials involving 752 mCRPC patients were available for the meta-analysis. According to our results, anemia was the most frequently observed grade 3-4 toxicity (24.1%), and dose reduction (26.9%) and treatment discontinuation (14.1%) were common events during PARPi treatment.

Clinicians should carefully consider these risks, especially taking into account that the use of PARPi in mCRPC patients is expected to rise in the near future.

Expert opinion on drug metabolism & toxicology. 2022 Apr 29 [Epub ahead of print]

Alessandro Rizzo, Veronica Mollica, Sara Merler, Franco Morelli, Giulia Sorgentoni, Marco Oderda, Matteo Santoni, Francesco Massari

Struttura Semplice Dipartimentale di Oncologia Medica per la Presa in Carico Globale del Paziente Oncologico, "Don Tonino Bello", I.R.C.C.S. Istituto Tumori "Giovanni Paolo II", Viale Orazio Flacco 65, 70124 Bari, Italy., Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni - 15, Bologna, Italy., U.O.C. Oncology, Azienda Ospedaliera Universitaria Integrata, University and Hospital Trust of Verona, 37126 Verona, Italy., Medical Oncology Unit, Gemelli Molise Hospital, Università Cattolica del Sacro Cuore, Campobasso, Italy., Oncology Unit, Macerata Hospital, Macerata, Italy., Department of Urology, San Giovanni Battista Hospital, Città della Salute e della Scienza, University of Turin, Turin, Italy.

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