PARP inhibitor era in ovarian cancer treatment: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Ovarian cancer is the eighth leading cause of cancer-related death among women, characterized by late diagnosis and a high relapse rate. In randomized controlled trials, we aimed to evaluate the efficacy and safety of PARP inhibitors (PARPi) in treating advanced ovarian cancer.

METHODS

This review was registered on PROSPERO (CRD42021283150), included all phase II and phase III randomized controlled trials (RCTs) assessing the effect of PARPi on ovarian cancer until the 13th of April, 2022. The main outcomes were progression- free survival (PFS), overall survival (OS), and adverse events (AEs). Pooled hazard ratios (HRs), and risk ratios (RRs) were calculated with 95% confidence intervals (95% CI). The random-effects model was applied in all analyses.

RESULTS

In the meta-analysis, 16 eligible RCTs were included, with a total of 5,815 patients. In recurrent ovarian cancer, PARPi maintenance therapy showed a significant PFS benefit over placebo in the total population (HR 0.34, CI 0.29-0.40), BRCA mutant (HR 0.24, CI 0.18-0.31), germline BRCA mutant (HR 0.23, CI 0.18-0.30), and BRCA wild-type cases (HR 0.50, CI 0.39-0.65). PARPi monotherapy also improved PFS (HR 0.62, CI 0.51-0.76) compared with chemotherapy in BRCAm patients with recurrent ovarian cancer. The use of PARPi maintenance therapy resulted in an improvement in PFS over placebo in newly-diagnosed cancers in the overall population (HR 0.46, CI 0.30-0.71) and the BRCAm population (HR 0.36, CI 0.29-0.44). Although the risk of severe AEs was increased by PARPi therapy compared to placebo in most settings investigated, these side effects were controllable with dose modification, and treatment discontinuation was required in the minority of cases.

CONCLUSIONS

PARPis are an effective therapeutic option for newly-diagnosed and recurrent ovarian cancer. Despite a minor increase in the frequency of serious adverse effects, they are generally well tolerated.

Trichomonas vaginalis infection is associated with increased risk of cervical carcinogenesis: A systematic review and meta-analysis of 470 000 patients

BACKGROUND

Trichomonas vaginalis infection is the most prevalent non-viral sexually transmitted infection (STI) in women and has been suggested as a risk factor for developing cervical cancer.

OBJECTIVE

We aimed to investigate the associations between T. vaginalis infection and cervical carcinogenesis.

SEARCH STRATEGY

A comprehensive systematic search was conducted in five databases on 21 October 2021.

SELECTION CRITERIA

Studies assessing the relationship between T. vaginalis infection, HPV co-infections, cervical dysplasia, and cervical cancer were found eligible.

DATA COLLECTION AND ANALYSIS

Summary estimates for pooled odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated with a random-effects model. Statistical heterogeneity was measured with I2 and Cochran's Q tests.

MAIN RESULTS

The 29 articles included 473 740 women, of whom 8518 were T. vaginalis-positive. Our results showed that T. vaginalis-infected women had 1.79 times higher odds of being diagnosed with HPV co-infection (95% CI 1.27-2.53; I2 95%). We also found that T. vaginalis infection was associated with high-grade squamous intraepithelial lesion diagnosis (OR 2.34, 95% CI 1.10-4.95; I2 75%) and cervical cancer (OR 5.23, 95% CI 3.03-9.04; I2 3%).

CONCLUSIONS

Our results showed an association between T. vaginalis and cervical carcinogenesis in sexually active women.

[The need, potential and unresolved issues of fertility preservation in the early stages of cervical cancer]

In the choice of a planned fertility preservation procedure for stage IA1 and IB1 cervical cancer, optimal oncological safety is the main focus of virtually all protocols. The surgeon should remove the appropriate proportion of the cervix for oncological safety, ensuring an adequate tumour-free surgical margin. However, some of the literature on fertility preservation, referring to histological parameters, still considers conisation with excellent fertility results to be optimal for the treatment of tumours with a diameter of 2 cm. With regard to fertility preservation in the case of radical trachelectomy versus simple conisation, we are aware of several ongoing studies, the results of which may provide an answer as to whether a more conservative surgical therapy for smaller tumours (less than 2 cm in diameter) represents an acceptable oncological safety.

Optimisation of a sol–gel synthesis route for the preparation of MgF2 particles for a large scale coating process

Preparation of transparent and low viscous MgF₂ sols via sol–gel technique which can be applied for antireflective coatings on glass substrates is described.

Laser Densification of Sol-Gel Derived TiO2 - Thin Films

Laser substrate heating is discussed as an alternative for the densification of sol -gel thin films. Homogeneous films of n(550 nm) = 2.30 could be obtained, keeping the bulk substrate temperature below 80 °C.

[Hindgut cyst in the presacral region]

Authors review a case of a 53 years old female patient with a cystic alteration 9 cm in diameter, located in the presacral region, in the medial line. Histological examination proved the mass to be a quite rare hindgut cyst which during surgery, however, did not show any connection with the rectum. The case is reported due to its relative rareness and the differential diagnostic questions emerging.