Major adverse cardiac events and cardiovascular toxicity with PARP inhibitors-based therapy for solid tumors: a systematic review and safety meta-analysis

Palazzo, Antonella; Ciccarese, Chiara; Iacovelli, Roberto; Cannizzaro, M.C.; Stefani, Agostina De; Salvatore, Lisa; Bria, Emilio

doi:10.1016/j.esmoop.2023.101154

Cited by 3 publications

(4 citation statements)

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“…MI, stroke, heart failure, and CV mortality) as primary endpoints, adequately powered statistical plans, and balanced baseline patient characteristics regarding prior CVDs and CV risk factors between treatment arms. Fourth, the potential for cardiotoxicity of newer therapies for mCRPC, such as poly-ADP-ribose polymerase inhibitors, should be further assessed and monitored ( 86 , 87 ).…”

Section: Discussionmentioning

confidence: 99%

Addressing the risk and management of cardiometabolic complications in prostate cancer patients on androgen deprivation therapy and androgen receptor axis-targeted therapy: consensus statements from the Hong Kong Urological Association and the Hong Kong Society of Uro-Oncology

Poon,

Tan,

Chan

et al. 2024

Front. Oncol.

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BackgroundAndrogen deprivation therapy (ADT) is the foundational treatment for metastatic prostate cancer (PCa). Androgen receptor (AR) axis-targeted therapies are a new standard of care for advanced PCa. Although these agents have significantly improved patient survival, the suppression of testosterone is associated with an increased risk of cardiometabolic syndrome. This highlights the urgency of multidisciplinary efforts to address the cardiometabolic risk of anticancer treatment in men with PCa.MethodsTwo professional organizations invited five urologists, five clinical oncologists, and two cardiologists to form a consensus panel. They reviewed the relevant literature obtained by searching PubMed for the publication period from April 2013 to April 2023, to address three discussion areas: (i) baseline assessment and screening for risk factors in PCa patients before the initiation of ADT and AR axis-targeted therapies; (ii) follow-up and management of cardiometabolic complications; and (iii) selection of ADT agents among high-risk patients. The panel convened four meetings to discuss and draft consensus statements using a modified Delphi method. Each drafted statement was anonymously voted on by every panelist.ResultsThe panel reached a consensus on 18 statements based on recent evidence and expert insights.ConclusionThese consensus statements serve as a practical recommendation for clinicians in Hong Kong, and possibly the Asia-Pacific region, in the management of cardiometabolic toxicities of ADT or AR axis-targeted therapies in men with PCa.

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Section: Discussionmentioning

confidence: 99%

Addressing the risk and management of cardiometabolic complications in prostate cancer patients on androgen deprivation therapy and androgen receptor axis-targeted therapy: consensus statements from the Hong Kong Urological Association and the Hong Kong Society of Uro-Oncology

Poon,

Tan,

Chan

et al. 2024

Front. Oncol.

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“…A re-analysis and update of a previously published meta-analysis was conducted [ 10 ]. Table S1 presents the population, intervention, comparison, outcome, and study design (PICOS) corresponding to the questions addressed in this study.…”

Section: Methodsmentioning

confidence: 99%

“…While one study on INO-1001, a PARP inhibitor, has shown promising results with respect to improving reperfusion injury, there is still a lack of direct evidence regarding the cardioprotective effects of PARP inhibitors against cardiotoxicity caused by anticancer agents [ 9 ]. One meta-analysis has attempted to assess the relationship between major adverse cardiac events (MACEs) and PARP inhibitors using data from studies conducted up to 30 April 2022 [ 10 ]. The findings revealed that combining PARP inhibitors with chemotherapy did not significantly increase the risk of MACEs ( p = 0.24).…”

Section: Introductionmentioning

confidence: 99%

“…The findings revealed that combining PARP inhibitors with chemotherapy did not significantly increase the risk of MACEs ( p = 0.24). However, when PARP inhibitors were combined with antiandrogens, there was a notable increase in the risk of MACEs (Peto odds ratio [OR] = 1.71; p = 0.02) [ 10 ]. However, this meta-analysis primarily focused on evaluating the potential cardiovascular toxicity of PARP inhibitors.…”

Section: Introductionmentioning

confidence: 99%

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Cardioprotective Effects of PARP Inhibitors: A Re-Analysis of a Meta-Analysis and a Real-Word Data Analysis Using the FAERS Database

Han,

Seo,

Kwon

et al. 2024

JCM

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Objective: This study aimed to assess the potential of PARP inhibitors to prevent cardiotoxicity. Methods: First, a re-analysis and update of a previously published study was conducted. Additional searches were conducted of the PubMed and Cochrane Central Register of Controlled Trials databases on 2 June 2023. After the selection process, the pooled odds ratio (OR) for cardiac adverse events (AEs) was calculated. Second, the FAERS database was examined for 10 frequently co-administered anticancer agents. The reporting odds ratio (ROR) was calculated based on the occurrence of cardiac AEs depending on the co-administration of PARP inhibitors. Results: Seven studies were selected for the meta-analysis. Although not statistically significant, co-administration of PARP inhibitors with chemotherapy/bevacizumab decreased the risk of cardiac AEs (Peto OR = 0.61; p = 0.36), while co-administration with antiandrogens increased the risk of cardiac AEs (Peto OR = 1.83; p = 0.18). A total of 19 cases of cardiac AEs were reported with co-administration of PARP inhibitors in the FAERS database. Co-administration of PARP inhibitors with chemotherapy/bevacizumab significantly decreased the risk of cardiac AEs (ROR = 0.352; 95% confidence interval (CI), 0.194–0.637). On the other hand, for antiandrogens co-administered with PARP inhibitors, the ROR was 3.496 (95% CI, 1.539–7.942). The ROR for immune checkpoint inhibitors co-administered with PARP inhibitors was 0.606 (95% CI, 0.151–2.432), indicating a non-significant effect on cardiac AEs. Conclusion: This study reports that PARP inhibitors show cardioprotective effects when used with conventional anticancer agents.

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Cardiovascular adverse events associated with PARP inhibitors for ovarian cancer: a real world study (RWS) with Bayesian disproportional analysis based on the FDA adverse event reporting system (FAERS)

Yang,

Song,

Sun

et al. 2024

Expert Opinion on Drug Safety

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Major adverse cardiac events and cardiovascular toxicity with PARP inhibitors-based therapy for solid tumors: a systematic review and safety meta-analysis

Cited by 3 publications

References 56 publications

Addressing the risk and management of cardiometabolic complications in prostate cancer patients on androgen deprivation therapy and androgen receptor axis-targeted therapy: consensus statements from the Hong Kong Urological Association and the Hong Kong Society of Uro-Oncology

Addressing the risk and management of cardiometabolic complications in prostate cancer patients on androgen deprivation therapy and androgen receptor axis-targeted therapy: consensus statements from the Hong Kong Urological Association and the Hong Kong Society of Uro-Oncology

Cardioprotective Effects of PARP Inhibitors: A Re-Analysis of a Meta-Analysis and a Real-Word Data Analysis Using the FAERS Database

Cardiovascular adverse events associated with PARP inhibitors for ovarian cancer: a real world study (RWS) with Bayesian disproportional analysis based on the FDA adverse event reporting system (FAERS)

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