Maintenance Therapy in Ovarian Cancer with Targeted Agents Improves PFS and OS: A Systematic Review and Meta-Analysis

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Background

Maintenance therapy with targeted agents for prolonging remission for ovarian cancer patients remains controversial. As a result, a meta-analysis was conducted to assess the effectiveness and safety of using maintenance therapy with targeted agents for the treatment of ovarian cancer.

Subgroup analysis

Two subgroups were initially divided based on whether targeted agents were combined with first-line therapy. In 2 trials, standard chemotherapy was combined with targeted agents as the first-line therapy, whereas in the remaining 11 trials the first-line therapy was standard chemotherapy only. There were no significant differences in therapeutic effectiveness (PFS, OS) between subgroups. There were also no significant differences between subgroups according to which targeted agents were employed (monoclonal antibody vs. small molecules). Finally, 2 subgroups were divided according to the withdrawal rate (>30% vs. <30%) of targeted maintenance therapy, and the results indicated that there were significant differences among them. One of the subgroups was insufficiently studied, which reduces the credibility of the results that were obtained in the above subgroup analyses.

 In conclusion, the results of our meta-analysis suggested that maintenance therapy with targeted agents may not only postpone the progress of ovarian cancer but may also improve survival. However, this treatment approach also increases the incidence of adverse events that are related to ovarian cancer. In our opinion, the above discussed pros and cons must be weighed with respect to the clinical application of using targeted maintenance therapy in ovarian cancer patients. Additional multi-center RCTs with larger patient cohorts should be required before maintenance therapy with targeted agents becomes a widely used clinical choice for the treatment of ovarian cancer.