Summary

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• This summary is based on the review of 24 systematic review(s)/meta-analysis(es). ^[1-24]
• General Effectiveness of Poly ADP-Ribose Polymerase (PARP) Inhibitors: In ovarian cancer patients, PARP inhibitors, including rucaparib, significantly improve progression-free survival (PFS), overall survival (OS), chemotherapy-free interval (CFI), time to first subsequent therapy or death (TFST), and time to second subsequent therapy or death (TSST) compared to placebo. In recurrent ovarian cancer with Breast Cancer Gene 1/2 (BRCA) mutations, rucaparib has shown an objective response rate (ORR) of 0.331.
• Comparative Effectiveness in Ovarian and Prostate Cancer: For BRCA-mutated ovarian cancer, rucaparib, olaparib, and niraparib all demonstrated significant PFS improvements compared to placebo. In metastatic castration-resistant prostate cancer (mCRPC), rucaparib shows comparable efficacy to other PARP inhibitors, such as olaparib, niraparib, and talazoparib, in improving radiographic progression-free survival (rPFS) and OS.
• Subgroup Effectiveness in BRCA and homologous recombination deficiency (HRD) Patients: Rucaparib is particularly effective in BRCA-mutated ovarian cancer and prostate cancer patients, and PARP inhibitors, including rucaparib, show improved PFS in HRD-positive ovarian cancer patients.
• Newly Diagnosed vs. Recurrent Cancer Efficacy: PARP inhibitors, including rucaparib, demonstrate effectiveness in both newly diagnosed and recurrent ovarian cancer cases, with specific improvements noted in BRCA-mutated and HRD-positive populations.
• General Safety of Rucaparib: In ovarian and prostate cancer treatments, rucaparib resulted in treatment-emergent adverse events (TEAEs) in 98.7% of patients, with 61% experiencing grade ≥3 events. Common adverse events included nausea, fatigue, vomiting, constipation, anemia, thrombocytopenia, elevated AST/ALT, and increased serum creatinine levels, with hematological toxicities, such as anemia, thrombocytopenia, and neutropenia, being particularly notable.
• Comparative Safety in Ovarian Cancer: In ovarian cancer, olaparib had fewer grade ≥3 adverse events compared to rucaparib and niraparib, with rucaparib and niraparib showing higher incidences of grade 3-4 toxicities. In metastatic castration-resistant prostate cancer (mCRPC), rucaparib’s safety profile was comparable to other PARP inhibitors, although hematological adverse events occurred more frequently with PARP inhibitors than with non-PARPi treatments.
• Rucaparib shows higher efficacy in ovarian and prostate cancer patients with BRCA mutations or HRD, with particularly beneficial outcomes in BRCA-mutated ovarian cancer and HRR-mutated mCRPC. Combination therapies with androgen receptor-targeted agents (ARTA) in prostate cancer enhance efficacy but may also increase the risk of adverse events.