The certainty of evidence is downgraded by study limitations (unclear allocation concealment in half of the studies).
A Cochrane review [Abstract] 1 included 5 studies with a total of 1474 subjects with breast cancer. There was a clear trend of small advantage in overall survival with poly ADP-ribose polymerase inhibitors (PARPi). In locally advanced/metastatic HER2-negative, BRCA germline mutated breast cancer, PARPi offer an improvement in progression-free survival (PFS), table T1. There was no statistical heterogeneity for these outcomes. Subgroup analyses for PFS outcomes based on trial level data were performed for triple-negative breast cancer, hormone-positive and/or HER2-positive breast cancer, and BRCA1 and BRCA2 germline mutations.
| Outcome | Relative effect (95% CI) | Risk with control | Risk with intervention (PARPi) | No of subjects (studies) Quality of evidence |
|---|---|---|---|---|
| Overall Survivalfollow up: 24 months | HR 0.84(0.76 to 1.00) | 550 per 1000 | 497 per 1000(446 to 550) | 1435(4) Moderate |
| Progression Free Survivalfollow up: 12 months | HR 0.63(0.56 to 0.71) | 625 per 1000 | 461 per 1000(423 to 502) | 1474(5) High |
| Response Rate | RR 1.39(1.24 to 1.54) | 489 per 1000 | 695 per 1000(636 to 749) | 1185(5) Low |
| Grade (severity al least 3) of adverse effects | RR 0.98(0.91 to 1.04) | 645 per 1000 | 620 per 1000(555 to 684) | 1443(5) Moderate |
Date of latest search: 2022-02-14
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