Influence of Residual Disease on the Efficacy of PARP Inhibitors in Advanced Epithelial Ovarian Cancer: A Systematic Review and Meta Analysis
Abstract
Simple Summary This systematic review and meta analysis evaluated six randomized controlled trials including 3629 patients to determine whether residual disease modifies the clinical benefit of PARP inhibitor maintenance therapy in advanced epithelial ovarian cancer. The analysis demonstrated that PARP inhibitors significantly improve progression-free survival in both patients with no gross residual disease (R0; hazard ratio 0.55, 95% confidence interval 0.44–0.68) and those with macroscopic residual disease (R1/R2; hazard ratio 0.51, 95% confidence interval 0.40–0.65). The treatment effect was similar between subgroups (p = 0.66). These findings indicate that PARP inhibitor maintenance therapy provides substantial benefit regardless of surgical outcome, supporting its use in all eligible patients after first-line platinum-based chemotherapy, while emphasizing that achieving complete cytoreduction remains vital for the best overall prognosis. Abstract Objective: While PARP inhibitors (PARPi) improve progression-free survival (PFS) in advanced ovarian cancer, their efficacy across different surgical outcomes is unclear. We aimed to determine if the efficacy of PARPi maintenance therapy, as measured by PFS, is modified by postoperative residual disease (R0 vs. R1/R2) in newly diagnosed advanced epithelial ovarian cancer. Methods: A systematic review and trial-level meta analysis of randomized controlled trials published through July 2025 was conducted. The primary endpoint was…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 3,629 participants or records.
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