{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T05:11:17Z","timestamp":1793682677392,"version":"4.5.1"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004434","name":"Universit\u00e0 degli Studi di Firenze","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004434","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Cancer Metastasis Rev"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Poly (ADP-ribose) polymerase (PARP) inhibitors (PARPis) are effective agents in different tumor types. A typical class of adverse events (AEs) associated with these agents, often leading to treatment modifications and discontinuations of treatment, is hematological toxicity. In our systematic review and safety meta-analysis, we investigated the incidence and risk of all grades and\u2009\u2265\u2009grade (G) 3 hematological AEs, including anemia, neutropenia, thrombocytopenia, and acute myeloid leukemia (AML)\/myelodysplastic syndrome (MDS) due to PARPis, used alone or in combination, in patients diagnosed with solid tumors.\u00a0This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. We systematically searched the PubMed, EMBASE, and Cochrane databases, the American Society of Clinical Oncology, and the European Society of Medical Oncology meeting abstracts for randomized clinical trials (RCTs) concerning the use of PARPis in patients with solid tumors. The search deadline was April 30, 2024. We calculated risk ratios (RRs) for all-grade and\u2009\u2265\u2009G3 AEs of PARPis versus non-PARPis.\u00a031 phase II\/III RCTs were included. Anemia was the most common all-grade (49.2%) and\u2009\u2265\u2009G3 AE (25.0%). The administration of PARPis significantly increased the risk of developing all grades of anemia (RR\u2009=\u20092.15, p\u2009&lt;\u20090.00001), neutropenia (RR\u2009=\u20091.50, p\u2009=\u20090.0002), and thrombocytopenia (RR\u2009=\u20092.59, p\u2009&lt;\u20090.00001) compared to non-PARPis. Similarly, a significant increase in the risk of\u2009\u2265\u2009G3 anemia (RR\u2009=\u20095.43, p\u2009&lt;\u20090.00001), neutropenia (RR\u2009=\u20091.70, p\u2009=\u20090.002), and thrombocytopenia (RR\u2009=\u20095.42, p\u2009&lt;\u20090.00001) was detected. PARPis did not increase the risk of AML\/MDS (p\u2009=\u20090.86).\u00a0PARPis increase the risk of hematologic toxicity compared to other treatments in solid tumors. Clinicians should be aware of this risk, especially given the expected increase in PARPis use in the next year in different tumor types.<\/jats:p>","DOI":"10.1007\/s10555-025-10283-1","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T02:58:46Z","timestamp":1755140326000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Hematological toxicity of parp inhibitors in solid tumors: a systematic review and safety meta-analysis"],"prefix":"10.1007","volume":"44","author":[{"given":"Brigida Anna","family":"Maiorano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Catalano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro Francesco Pio","family":"Maiorano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio","family":"Signori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Loizzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gennaro","family":"Cormio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Reni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giandomenico","family":"Roviello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Necchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,14]]},"reference":[{"key":"10283_CR1","doi-asserted-by":"publisher","unstructured":"Guo, Y., Fan, B., & Li, \u00b7 Mo. (2023). PARP molecular functions and applications of PARP inhibitors in cancer treatment. Genome Instability & Disease 4(3), 137\u2013153https:\/\/doi.org\/10.1007\/S42764-023-00100-W","DOI":"10.1007\/S42764-023-00100-W"},{"issue":"25","key":"10283_CR2","doi-asserted-by":"publisher","first-page":"2257","DOI":"10.1200\/JCO.18.02050","volume":"37","author":"C Gourley","year":"2019","unstructured":"Gourley, C., Balma\u00f1a, J., Ledermann, J. A., Serra, V., Dent, R., Loibl, S., Pujade-Lauraine, E., & Boulton, S. J. (2019). Moving from poly (ADP-ribose) polymerase inhibition to targeting DNA repair and DNA damage response in cancer therapy. Journal of Clinical Oncology, 37(25), 2257\u20132269. https:\/\/doi.org\/10.1200\/JCO.18.02050","journal-title":"Journal of Clinical Oncology"},{"key":"10283_CR3","doi-asserted-by":"publisher","unstructured":"Zhou, J. Xin, Feng, L. Jin, & Zhang, X. (2017). Risk of severe hematologic toxicities in cancer patients treated with PARP inhibitors: a meta-analysis of randomized controlled trials. Drug Design, Development and Therapy, 11, 3009https:\/\/doi.org\/10.2147\/DDDT.S147726","DOI":"10.2147\/DDDT.S147726"},{"key":"10283_CR4","doi-asserted-by":"publisher","unstructured":"Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., \u2026 Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. The BMJ, 372. https:\/\/doi.org\/10.1136\/BMJ.N71","DOI":"10.1136\/BMJ.N71"},{"key":"10283_CR5","unstructured":"Cancer Institute, N. (2017). Common Terminology Criteria for Adverse Events (CTCAE) Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Retrieved from https:\/\/www.meddra.org\/"},{"key":"10283_CR6","doi-asserted-by":"publisher","unstructured":"Appendix: Jadad Scale for Reporting Randomized Controlled Trials. (2005). 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