PARP inhibitor use associated with MDS, AML risk
medwireNews: The results of a meta-analysis point to a link between PARP inhibitor use and a small increase in the risk for developing myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML).
Joachim Alexandre (Caen University Hospital, France) and co-authors collated data from 18 randomized controlled trials with 7307 patients with ovarian, lung, breast, and prostate cancer and other tumors. In all, 0.73% of participants given a PARP inhibitor developed the hematologic adverse events compared with 0.47% of those given placebo.
Patients using a PARP inhibitor were 2.63 times more likely to develop these hematologic adverse events than those given placebo, the team reports in The Lancet Haematology.
Of concern, the WHO pharmacovigilance database indicated that 45% of patients found to have developed MSD or AML after PARP inhibitor therapy had died.
While all cases of MDS and AML occurred in ovarian cancer patients given PARP inhibitors as a maintenance therapy, Alexandre et al believe this may be due to longer follow-up in these trials than those in other settings, “thus increasing the likelihood of detecting these rare and delayed adverse events.”
They advise that “[c]linicians need to remain vigilant in evaluating delayed haematological toxicities in patients treated with PARP inhibitors,” especially when used in the maintenance setting.
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