Impact of PARP Inhibitors on Health-related Quality of Life in Patients with Metastatic Castration-resistant Prostate Cancer: A Systematic Review and Meta-analysis
Bibliographic record
Abstract
Background and objective PARP inhibitor (PARPi) agents, alone or in combination with antiandrogens, are considered a standard of care for patients with metastatic castration-resistant prostate cancer (mCRPC). This meta-analysis evaluates the impact of PARPi agents on health-related quality of life (HRQoL) using data from prospective trials. Methods In this prospectively registered systematic review and meta-analysis (PROSPERO: CRD420251011282), we searched the MEDLINE, Embase, and Web of Science databases in March 2025 for prospective trials assessing the impact of PARPi on patient HRQoL in mCRPC. Results for the mean differences (MD) in Functional Assessment of Cancer Therapy-Prostate (FACT-P) total scores at early and late time points were pooled using a random-effects model. Key findings and limitations Reports for seven prospective trials (2861 patients) were included. The PROfound trial ( n = 387) demonstrated a clinically meaningful improvement in global HRQoL (MD from baseline: 6.7, 95% confidence interval [CI] 1.5–12), while the remaining six studies ( n = 2474) did not show a clinically meaningful impact individually. In pooled analysis for the PROpel, MAGNITUDE, and NCT01972217 randomised controlled trials ( n = 911), no clinically meaningful differences in the change in FACT-P total score were observed at early (weeks 8–9: MD −1.4, 95%CI −3.0 to 0.2) or late (weeks 96–101: MD −2.1, 95%CI −8.9 to 4.8) time points. Six studies were rated as having some/moderate concerns regarding bias, and one was considered at high risk of bias because of baseline stratification by symptom status. Conclusions and clinical implications We observed no statistically or clinically meaningful deterioration in HRQoL with PARPi treatment in patients with mCRPC, with one study suggesting a potential benefit. Predefined thresholds may not capture the individual and complex nature of HRQoL in the palliative mCRPC setting, where even modest changes can have important clinical and personal significance, which underscores the importance of nuanced interpretation of HRQoL data in guiding treatment decisions. Patient summary We did not find evidence that drugs called PARP inhibitors have a negative effect on health-related quality of life (HRQoL) for men with advanced prostate cancer. However, the current tools used to measure HRQoL may not fully reflect the individual and complex experiences of patients receiving palliative treatment for their cancer.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.024 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.017 | 0.040 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".