Important Facts About PARP Inhibitors
- PARP inhibitors can extend life for some women with ovarian cancer.
- The use of PARP Inhibitors is steered by examining the molecular profile of your cancer.
- New guidelines recommend all women should be offered these drugs regardless of mutational status.
- The drugs come with a range of likely but treatable side effects that may require adjustments to dosage and scheduling.
While PARP inhibitors are available to almost all women, women with BRCA gene mutations or who are HRD proficient may benefit the most from these drugs. However, the American Society of Clinical Oncology (ASCO) guidelines recommend PARP inhibitors be offered to women, with or without genetic mutations, who are newly diagnosed with stage III or IV ovarian cancer and have improved with chemotherapy.
Read MoreAre They Right for You?
Depending on other medications you take or other medical conditions you’re dealing with, PARP inhibitors may not be ideal. “There are definitely side effects," says Dr. Wethington. “If you have certain blood count issues or bone marrow issues, PARP inhibitors may not be the best option for you.” Some interactions with other medications prevent their effectiveness altogether. And while you’re using these drugs, you must be closely monitored for fatigue, gastrointestinal upset, anemia, and bone marrow impairment. There’s also an increased risk of infection with PARP inhibitor use. But a skillful gynecologic oncologist can coordinate the steps in your treatment, adjust dosages as needed, and find the ideal schedule of treatment. When these parts come together, the benefits of PARP inhibitors can be enormous.Individual Treatment Plans
Tailoring the drug to a patient's individual profile is essential. "There are guidelines to help us start but there's always some flexibility within them," she says. "Dosages are not chosen based on an individual patient, they're chosen based on a population. And so for some people a slightly different dose may be needed."
So should PARP Inhibitors be a piece of the puzzle in addressing your individual needs as an ovarian cancer patient? "There are multiple time points at which to use PARP inhibitors and so it gets more subtle than just yes/no," Dr. Wethington explains. “It's yes/no and when. Patients who carry a BRCA mutation or an inherited risk of developing ovarian cancer benefit particularly well,” she continues. And while not all patients should take these drugs, “many should, and your doctor would be the best person to sort if out for you.”
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