Summary

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• This summary is based on the review of 16 systematic review(s)/meta-analysis(es). ^[1-16]
• Radiographic Progression-Free Survival (rPFS) and Overall Survival (OS): No significant difference in Event-Free Survival (EFS) or OS was observed between intermittent pegylated-asparaginase (PEG-asp) (eight doses) and continuous PEG-asp (15 doses) in non-high-risk acute lymphoblastic leukemia (ALL) patients, as well as between low-risk standard treatment with additional PEG-asp (six doses) and standard treatment (two doses), with risk ratios (RR) close to 1. In metastatic castration-resistant prostate cancer (mCRPC), olaparib demonstrated a significant improvement in rPFS with a hazard ratio (HR) of 0.67 (95% confidence interval (CI): 0.46-0.96) when compared to niraparib and talazoparib, while no significant differences were observed in OS among these treatments. Talazoparib plus enzalutamide had a lower probability of being the most effective for rPFS (13%) and OS (19%) compared to a nonstandard dose of docetaxel.
• Progression-Free Survival (PFS) and OS in BReast CAncer (BRCA)-Mutated Metastatic Breast Cancer (MBC): Both olaparib and talazoparib significantly improved PFS with HRs of 0.64 and 0.54, respectively, compared to standard chemotherapy; however, there were no significant differences in OS.
• Combination Therapies: polymerase (PARP) inhibitor (PARPi) and androgen receptor signaling inhibitor (ARSI) combinations improved rPFS (HR: 0.62) and OS (HR: 0.84) compared to ARSI alone in mCRPC.
• Objective Response Rate (ORR) in BRCA-Mutated HER2-Negative MBC: Both olaparib and talazoparib exhibited higher ORRs than standard chemotherapy, indicating greater efficacy in this population.
• Hematological Toxicities: Talazoparib significantly increased the risk of all grades and ≥G3 anemia, neutropenia, and thrombocytopenia compared to non-PARP inhibitors. It also presented a higher risk of treatment interruption and dose reduction due to adverse events compared to other PARP inhibitors.
• Adverse Events (AEs): Talazoparib had a higher incidence of grade ≥3 adverse events, with an odds ratio of 3.7 when compared to olaparib and niraparib. In contrast, olaparib and rucaparib did not significantly increase the incidence of grade ≥3 AEs.
• Serious AEs (SAEs) and Discontinuation: There were no significant differences in the occurrence of serious adverse events or discontinuation related to adverse events among olaparib, rucaparib, niraparib, and talazoparib.
• BRCA-Mutated Populations: There is significant efficacy of PARP inhibitors (PARPis), including talazoparib, in BRCA-positive patients with mCRPC and MBC, with additional evidence of efficacy for PARPi combined with ARSI in HRR-proficient mCRPC. Careful monitoring for increased hematological toxicities is recommended for patients using talazoparib, especially in those with mCRPC.