MEK inhibitor as single agent in low grade serous ovarian and peritoneal cancer: a systematic review and meta-analysis.


Journal

Cancer treatment reviews
ISSN: 1532-1967
Titre abrégé: Cancer Treat Rev
Pays: Netherlands
ID NLM: 7502030

Informations de publication

Date de publication:
Nov 2022
Historique:
received: 13 06 2022
revised: 13 08 2022
accepted: 14 08 2022
pubmed: 6 9 2022
medline: 18 10 2022
entrez: 5 9 2022
Statut: ppublish

Résumé

Low grade serous carcinoma of the ovary and peritoneum (LGSC) is characterized by low response rates to chemotherapy and by MAPK pathway alterations. Phase II/III clinical trials tested different MEK inhibitors (MEKis) in this complex malignancy, with heterogenous results. Purpose of this systematic review and meta-analysis is to define activity and efficacy of these agents and explore differences in clinical outcomes related to RAS/RAF mutational status. In March 2022, we searched Pubmed, Web of Science, Scopus, and the major conference proceedings (ASCO, ESMO) for randomized and non-randomized clinical trials evaluating MEKi as single agent in recurrent LGSC. The screening was performed independently by two reviewers. Objective response rate (ORR) and progression-free survival (PFS) data were extracted, and RevMan 5.3 software was used for statistical analysis. A total of 4 clinical trials involving 648 patients were included. In the intention-to-treat population, use of a MEK inhibitor was not associated with a significant improvement in PFS, with a pooled Hazard Ratio equal to 0.75 (95 % CI: 0.30 - 1.86, P = 0.54). Heterogeneity was significant (I Although no statistically significant improvement in PFS was demonstrated, the available data show clear signals of activity, at least for some MEKis.

Sections du résumé

BACKGROUND BACKGROUND
Low grade serous carcinoma of the ovary and peritoneum (LGSC) is characterized by low response rates to chemotherapy and by MAPK pathway alterations. Phase II/III clinical trials tested different MEK inhibitors (MEKis) in this complex malignancy, with heterogenous results. Purpose of this systematic review and meta-analysis is to define activity and efficacy of these agents and explore differences in clinical outcomes related to RAS/RAF mutational status.
METHODS METHODS
In March 2022, we searched Pubmed, Web of Science, Scopus, and the major conference proceedings (ASCO, ESMO) for randomized and non-randomized clinical trials evaluating MEKi as single agent in recurrent LGSC. The screening was performed independently by two reviewers. Objective response rate (ORR) and progression-free survival (PFS) data were extracted, and RevMan 5.3 software was used for statistical analysis.
RESULTS RESULTS
A total of 4 clinical trials involving 648 patients were included. In the intention-to-treat population, use of a MEK inhibitor was not associated with a significant improvement in PFS, with a pooled Hazard Ratio equal to 0.75 (95 % CI: 0.30 - 1.86, P = 0.54). Heterogeneity was significant (I
CONCLUSIONS CONCLUSIONS
Although no statistically significant improvement in PFS was demonstrated, the available data show clear signals of activity, at least for some MEKis.

Identifiants

pubmed: 36063572
pii: S0305-7372(22)00127-X
doi: 10.1016/j.ctrv.2022.102458
pii:
doi:

Substances chimiques

Protein Kinase Inhibitors 0
Mitogen-Activated Protein Kinase Kinases EC 2.7.12.2

Types de publication

Journal Article Meta-Analysis Review Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

102458

Informations de copyright

Copyright © 2022 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Lucia Musacchio (L)

Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Anna Amela Valsecchi (AA)

Department of Oncology, University of Torino at Ordine Mauriziano Hospital, Turin, Italy.

Vanda Salutari (V)

Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Giorgio Valabrega (G)

Department of Oncology, University of Torino at Ordine Mauriziano Hospital, Turin, Italy.

Floriana Camarda (F)

Comprehensive Cancer Center, Agostino Gemelli University Polyclinic (IRCCS), Rome, Italy.

Valentina Tuninetti (V)

Department of Oncology, University of Torino at Ordine Mauriziano Hospital, Turin, Italy.

Gaia Giannone (G)

Imperial College London Division of Cancer, Department of Surgery and Cancer, London, United Kingdom.

Michele Bartoletti (M)

Unit of Medical Oncology and Cancer Prevention, Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Italy.

Claudia Marchetti (C)

Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Sandro Pignata (S)

Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Napoli, Italy.

Anna Fagotti (A)

Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.

Giovanni Scambia (G)

Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.

Massimo Di Maio (M)

Department of Oncology, University of Torino at Ordine Mauriziano Hospital, Turin, Italy. Electronic address: massimo.dimaio@unito.it.

Domenica Lorusso (D)

Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH