RAS/RAF/MEK/ERK（MAPK）通路在卵巢癌发生中起作用。低级别浆液性卵巢癌（LGSOC）常携带激活的MAPK突变。MAPK抑制剂已被用于小型卵巢癌（OC）患者以控制肿瘤生长。因此，我们进行了Meta分析，评估MAPK抑制剂在OC患者中的有效性。我们旨在确定临床获益率（CBR），具有最佳CBR和总响应率（ORR）的MAPK抑制剂亚组，以及最常见的不良事件。我们在PubMed、Ovid的Embase、Cochrane库和clinicaltrials.gov上搜索了评估单一MAPK通路抑制剂在OC患者中的疗效的研究。我们的主要结局包括CBR，其定义为具有稳定疾病（SD）、完全（CR）和部分反应（PR）的患者比例。次要结局包括ORR（包括PR和CR）和三级和四级不良事件。采用随机效应模型进行Meta分析。我们包括了9项研究，共319名OC患者，确定了一个汇总CBR为63％（95% CI 39-84％，I2=92％）。联合治疗RAF和MEK抑制剂在BRAFv600突变的LGSOC（n = 6）中具有最大的疗效，CBR为100％，ORR为83％。MEK抑制剂作为单一剂量具有最好的疗效。肿瘤组织学亚组分析表明LGSOC患者的CBR和ORR显著更高，汇总CBR和ORR分别为87％（95% CI 81-92％，I2=0％）和27％（95% CI 10-48％，I2=77％）。三级或更高级别的不良事件频繁报道：167名患者中有123例。MEK抑制剂是（LGS）OC中最有前途的单一剂量。但是，在具有BRAFv600突变或治疗选择受限的非突变OC患者中，应考虑双重MAPK通路抑制剂因其更高的疗效和可耐受的毒副反应配置。 版权所有©2023年作者。由Elsevier Inc.发表。保留所有权利。

The RAS/RAF/MEK/ERK (MAPK) pathway plays a role in ovarian carcinogenesis. Low-grade serous ovarian carcinoma (LGSOC) frequently harbors activating MAPK mutations. MAPK inhibitors have been used in small subsets of ovarian carcinoma (OC) patients to control tumor growth. Therefore, we performed a meta-analysis to evaluate the effectiveness of MAPK inhibitors in OC patients. We aimed to determine the clinical benefit rate (CBR), the subgroup of MAPK inhibitors with the best CBR and overall response rate (ORR), and the most common adverse events.We conducted a search in PubMed, Embase via Ovid, the Cochrane library and clinicaltrials.gov on studies evaluating the efficacy of single MAPK pathway inhibition with MAPK pathway inhibitors in OC patients. Our primary outcome included the CBR, defined by the proportion of patients with stable disease (SD), complete (CR) and partial response (PR). Secondary outcomes included the ORR (including PR and CR) and grade 3 and 4 adverse events. Meta-analysis was performed using a random-effects model.We included nine studies with a total of 319 OC patients, for which we determined a pooled CBR of 63% (95%-CI 39-84%, I2 = 92%). Combined treatment with Raf- and MEK inhibitors in in BRAFv600 mutated LGSOC (n = 6) had the greatest efficacy with a CBR of 100% and ORR of 83%. MEK inhibitors had the best efficacy as a single agent. Subgroup analysis by tumor histology demonstrated a significantly higher CBR and ORR in patients with LGSOC, with a pooled CBR and ORR of 87% (95%-CI 81-92%, I2 = 0%) and 27% (95%-CI 10-48%, I2 = 77%) respectively. Adverse events of grade 3 or higher were reported frequently: 123 in 167 patients.MEK inhibitors are the most promising single agents in (LGS)OC. However, dual MAPK pathway inhibition should be considered in patients with a BRAFv600 mutation, or non-mutated OC with depleted treatment options due indications of higher efficacy and tolerable toxicity profiles.Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.