Objective  To evaluate the efficacy, safety and economy of poly ADP ribose polymerase (PARP) inhibitors for the treatment of recurrent ovarian cancer by rapid health technology assessment (rHTA), and to provide evidence for clinicians and policy makers.

Methods  PubMed, Cochrane Library, Embase, CNKI, WanFang Data, SinoMed databases, and the official websites of the health technology assessment (HTA) agency were electronically searched to collect systematic reviews/Meta-analysis, pharmacoeconomic studies and HTA reports on PARP inhibitors for the treatment of recurrent ovarian cancer from inception through October 20, 2025. Two reviewers independently identified studies, extracted data, assessed the quality of included studies, and descriptively analyzed and summarized the results.

Results  A total of 18 articles were included, including 10 systematic reviews/Meta-analysis, 7 pharmacoeconomic studies and 1 HTA report. In terms of efficacy, PARP inhibitors significantly improve the progression-free survival (PFS) and overall survival (OS) of patients with recurrent ovarian cancer. No statistically significant difference in PFS was observed among different PARP inhibitors. However, olaparib may prolong the OS of patients with BRCA-mutated platinum-sensitive recurrent ovarian cancer. Regarding safety, there were differences in the incidence of severe adverse events (SAEs) across different PARP inhibitors. Niraparib was associated with a higher incidence of severe hematological adverse events, while olaparib had the lowest incidence of SAEs, presenting a relatively favorable safety profile. In terms of economy, research findings varied substantially due to differences in medical policies, time of study, analytical perspectives, willingness-to-pay thresholds, and other factors among different countries.

Conclusion  PARP inhibitors demonstrate significant efficacy in the treatment of patients with recurrent ovarian cancer, with an overall controllable safety profile. Nevertheless, differences exist in the incidence of SAEs between different PARP inhibitors. At present, the current evidence of domestic economic evaluations is insufficient and further assessment is needed.

1.Kuroki L, Guntupalli SR. Treatment of epithelial ovarian cancer[J]. BMJ, 2020, 371: m3773. DOI: 10.1136/bmj.m3773.

2.Siegel RL, Miller KD, Wagle NS, et al. Cancer statistics, 2023[J]. CA Cancer J Clin, 2023, 73(1): 17-48. DOI: 10.3322/caac.21763.

3.Torre LA, Trabert B, DeSantis CE, et al. Ovarian cancer statistics,  2018[J]. CA Cancer J Clin, 2018, 68(4): 284-296. DOI: 10.3322/caac.21456.

4.Pignata S, Cecere SC, Du Bois A, et al. Treatment of recurrent ovarian cancer[J]. Ann Oncol, 2017, 28(suppl_8): viii51-viii56. DOI: 10.1093/annonc/mdx441.

5.Jiang X, Tang H, Chen T. Epidemiology of gynecologic cancers in China[J]. J Gynecol Oncol, 2018, 29(1): e7. DOI: 10.3802/jgo.2018.29.e7.

6.Morgan RD, Clamp AR, Evans DGR, et al. PARP inhibitors in platinum-sensitive high-grade serous ovarian cancer[J]. Cancer Chemother Pharmacol, 2018, 81(4): 647-658. DOI: 10.1007/s00280-018-3532-9.

7.Mirza MR, Monk BJ, Herrstedt J, et al. Niraparib maintenance therapy in platinum-sensitive,recurrent ovarian cancer[J]. N Engl J Med, 2016, 375(22): 2154-2164. DOI: 10.1056/NEJMoa1611310.

8.Ledermann J, Harter P, Gourley C, et al. Olaparib maintenance therapy in platinum-sensitive relapsed ovarian cancer[J]. N Engl J Med, 2012, 366(15): 1382-1392. DOI: 10.1056/NEJMoa1105535.

9.钱晨月, 胡展红, 徐敏芹, 等. 阿托西班治疗早产的快速卫生技术评估[J]. 中国医院药学杂志, 2022, 42(10): 1041-1045. [Qian CY, Hu ZH, Xu MQ, et al. Rapid health technology assessment of atosiban in the treatment of preterm labor[J]. Chinese Journal of Hospital Pharmacy, 2022, 42(10): 1041-1045.] DOI: 10.13286/j.1001-5213.2022.10.12.

10.蓝春燕, 王雅卓, 张师前. 铂敏感复发性卵巢癌诊治中国专家共识（2023年版）[J]. 中国实用妇科与产科杂志, 2023, 39(9): 935-942. DOI: 10.19538/j.fk2023090117.

11.Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both[J]. BMJ, 2017, 358: j4008. DOI: 10.1136/bmj.j4008.

12.Husereau D, Drummond M, Augustovski F, et al. Consolidated health economic evaluation reporting standards 2022 (CHEERS 2022) statement:updated reporting guidance for health economic evaluations[J]. BMC Health Serv Res, 2022, 22(1): 114. DOI: 10.1186/s12913-021-07460-7.

13.Hailey D. Toward transparency in health technology assessment: a checklist for HTA reports[J]. Int J Technol Assess Health Care, 2003, 19(1): 1-7. DOI: 10.1017/s0266462303000011.

14.姚媛, 苏芬丽, 孙旭, 等. 度拉糖肽治疗2型糖尿病的快速卫生技术评估[J]. 药物流行病学杂志, 2023, 32(8): 931-940. [Yao Y, Su FL, Sun X, et al. Rapid health technology assessment of dulaglutide for the treatment of type 2 diabetes mellitus[J]. Chinese Journal of Pharmacoepidemiology, 2023, 32(8): 931-940.] DOI: 10.19960/j.issn.1005-0698.202308012.

15.Staropoli N, Ciliberto D, Del Giudice T, et al. The era of PARP inhibitors in ovarian cancer: "Class Action" or not? a systematic review and Meta-analysis[J]. Crit Rev Oncol Hematol, 2018, 131: 83-89. DOI: 10.1016/j.critrevonc.2018.08.011.

16.陶继英. PARP抑制剂治疗复发性卵巢癌的有效性和安全性评价[D]. 云南大理: 大理大学, 2019. DOI: 10.27811/d.cnki.gdixy.2019.000163.

17.Gong H, Nie D, HuangY, et al. Poly (ADP-ribose) polymerase (PARP) inhibitor regimens for ovarian cancer in phase III randomized controlled trials: a network Meta-analysis[J]. Int J Gynecol Cancer, 2020, 30(10): 1576-1582. DOI: 10.1136/ijgc-2020-001373.

18.Stemmer A, Shafran I, Stemmer SM, et al. Comparison of poly (ADP-ribose) polymerase inhibitors (PARPis) as maintenance therapy for platinum-sensitive ovarian cancer: systematic review and network Meta-analysis[J]. Cancers (Basel), 2020, 12(10): 3026. DOI: 10.3390/cancers12103026.

19.Xu Y, Ding L, Tian Y, et al. Comparative efficacy and safety of PARP inhibitors as maintenance therapy in platinum sensitive recurrent ovarian cancer: a network Meta-analysis[J]. Front Oncol, 2020, 10: 573801. DOI: 10.3389/fonc.2020.573801.

20.Wang H, Wu M, Liu H, et al. Comparison of the efficacy and safety of PARP inhibitors as a monotherapy for platinum-sensitive recurrent ovarian cancer: a network Meta-analysis[J]. Front Oncol, 2021, 11: 785102. DOI: 10.3389/fonc.2021.785102.

21.Luo J, Ou S, Wei H, et al. Comparative efficacy and safety of poly (ADP-ribose) polymerase inhibitors in patients with ovarian cancer: a systematic review and network Meta-analysis[J]. Front Oncol, 2022, 12: 815265. DOI: 10.3389/fonc.2022.815265.

22.Zhou S, Jiang Y, LuoC, et al. Comparison of poly (ADP-ribose) polymerase inhibitors (PARPis) as maintenance therapy for newly-diagnosed and platinum-sensitive recurrent ovarian cancer with BRCA mutational status: a systematic review and network Meta-analysis[J]. Expert Rev Anticancer Ther, 2024, 24(1-2): 59-69. DOI: 10.1080/14737140.2023.2298832.

23.Ji S, Chen L, Yu Y, et al. A comprehensive comparison of PARP inhibitors as maintenance therapy in platinum-sensitive recurrent ovarian cancer: a systematic review and network Meta-analysis[J]. J Ovarian Res, 2025, 18(1): 18. DOI: 10.1186/s13048-025-01599-1.

24.钟红, 邓慧远, 张玄羿, 等. 多腺苷二磷酸核糖聚合酶抑制剂单药治疗铂敏感复发性卵巢癌有效性及安全性的网状Meta分析[J]. 中国新药与临床杂志, 2025, 44(7): 549-554. [Zhong H, Deng HY, Zhang XY, et al. Comparison of efficacy and safety of PARP inhibitors as a monotherapy for platinum-sensitive recurrent ovarian cancer: a network Meta-analysis[J]. Chinese Journal of New Drugs and Clinical Remedies, 2025, 44(7): 549-554.] DOI: 10.14109/j.cnki.xyylc.2025.07.12.

25.Liu AY, Cohen JG, Walsh C, et al. A cost-effectiveness analysis of three PARP inhibitors for maintenance therapy in platinum-sensitive recurrent ovarian cancer[J]. Gynecol Oncol, 2017, 147(1): 196. DOI: 10.1016/j.ygyno.2017.07.025.

26.Fisher M, Guy H, Walder L, et al. Cost-effectiveness of niraparib versus routine surveillance and olaparib for the maintenance treatment of adult patients with ovarian cancer in the United States[J]. J Clin Onco, 2018, 36: 5559. DOI: 10.1200/JCO.2018.36.15_suppl.5559.

27.Zhong L, Tran AT, Tomasino T, et al. Cost-effectiveness of nNiraparib and olaparib as maintenance therapy for patients with platinum-sensitive recurrent ovarian cancer[J]. J Manag Care Spec Pharm, 2018, 24(12): 1219-1228. DOI: 10.18553/jmcp.2018.24.12.1219.

28.Guy H, Walder L, Fisher M. Cost-effectiveness of niraparib versus routine surveillance, olaparib and rucaparib for the maintenance treatment of patients with ovarian cancer in the United States[J]. Pharmacoeconomics, 2019, 37(3): 391-405. DOI: 10.1007/s40273-018-0745-z.

29.Leung JH, Lang HC, Wang SY, et al. Cost-effectiveness analysis of olaparib and niraparib as maintenance therapy for women with recurrent platinum-sensitive ovarian cancer[J]. Expert Rev Pharmacoecon Outcomes Res, 2022, 22(3): 489-496. DOI: 10.1080/14737167.2021.1954506.

30.Nie J, Wu H, Sun L, et al. Cost-effectiveness of fuzuloparib compared to routine surveillance, niraparib and olaparib for maintenance treatment of patients with germline BRCA1/2 mutation and platinum-sensitive recurrent ovarian carcinoma in China[J]. Front Pharmacol, 2022, 13: 987337. DOI: 10.3389/fphar.2022.987337.

31.Alkhuzam K, Guan D, Aroza R, et al. EE147 The cost-effectiveness of olaparib compared to niraparib in the treatment of recurrent ovarian cancer caused by BRCA1 and BRCA2 gene mutation from a US healthcare payer perspective[J]. Value Health, 2022, 25(7): S363. DOI: 10.1016/j.jval.2022.04.397.

32.CADTH. Niraparib (Zejula) for ovarian cancer[R/OL]. (2020-09-03) [2025-11-01]. https://www.cda-amc.ca/sites/default/files/pcodr/Reviews2020/10203NiraparibOC_InitialRec_Approved_03Jul2020_final.

33.Pujade Lauraine E, Ledermann JA, Selle F, et al. Olaparib tablets as maintenance therapy in patients with platinum-sensitive, relapsed ovarian cancer and a BRCA1/2 mutation (SOLO2/ENGOT-Ov21): a double-blind, randomised, placebo-controlled,phase 3 trial[J]. Lancet Oncol, 2017, 18(9): 1274-1284. DOI: 10.1016/S1470-2045(17)30469-2.

34.Li N, Zhang Y, Wang J, et al. Fuzuloparib maintenance therapy in patients with platinum-sensitive,recurrent ovarian carcinoma (FZOCUS-2): a multicenter, randomized, double-blind, placebo-controlled, phase Ⅲ trial[J]. J Clin Oncol, 2022, 40(22): 2436-2446. DOI: 10.1200/JCO.21.01511.

35.Kaufman B, Shapira-Frommer R, Schmutzler RK, et al. Olaparib monotherapy in patients with advanced cancer and a germline BRCA1/2 mutation[J]. J Clin Oncol. 2015, 33(3): 244-250. DOI: 10.1200/JCO.2014.56.2728.

36.Murai J, Huang SY, Das BB, et al. Trapping of PARP1 and PARP2 by clinical PARP inhibitors[J]. Cancer Res, 2012, 72: 5588-5599. DOI: 10.1158/0008-5472.CAN-12-2753.

37.Murai J, Huang SY, Renaud A, et al. Stereospecific PARP trapping by BMN 673 and comparison with olaparib and rucaparib[J]. Mol Cancer Ther, 2014, 13: 433-443. DOI: 10.1158/1535-7163.MCT-13-0803.

38.国家统计局. 中华人民共和国2024年国民经济和社会发展统计公报[EB/OL]. (2025-02-28) [2025-11-01]. https://www.stats.gov.cn/sj/tjgb/ndtjgb/qgndtjgb/202502/t202502281958821.html.