Marmouset and colleagues describe an association between certain clinical and laboratory parameters and previous exposure to PARP inhibitors (PARPi; ref. 1). There are however important confounders, perhaps inappropriately correlating therapy-related myeloid neoplasms (t-MN) to PARPi, that are important to highlight.
The authors report a cumulative incidence of t-MN of 3.5% and a 66% increase in t-MN but it was not reported whether the number of patients seen for ovarian cancer have remained the same. Also, patients with ovarian cancer are exposed to platinum agents and taxanes, thus the attribution of t-MN to PARPi is unclear. Because chemotherapies are also associated with secondary malignancies, the evaluation of prior agents is critical for the correct attribution of t-MN to PARPi.
The authors compare features of PARPi-exposed patients with t-MN referred to hematology consultation for cytopenia with those who did not develop t-MN. Patients with t-MN had a longer exposure to PARPi,...