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abstract: the Oncologist
June 2, 2016
Our primary objective is
to review the safety and tolerability profile of olaparib, a novel
anticancer therapy, and to discuss
key considerations for symptom management in
patients with advanced ovarian cancer. Olaparib is the first of a new
class of
anticancer therapies, poly (ADP-ribose)
polymerase (PARP) inhibitors that target tumors that have deficits in
homologous recombination
repair (such as BRCA mutations) by a
process known as synthetic lethality. Through this process, neither the
deficiency in homologous recombination
repair nor PARP inhibition alone is cytotoxic,
but the combination of these two conditions leads to cell death. In
December
2014, olaparib received accelerated approval by
the U.S. Food and Drug Administration (FDA) as monotherapy for patients
with
known or suspected deleterious germline BRCA-mutated
(as detected by an FDA-approved test) advanced ovarian cancer who had
been treated with at least three lines of chemotherapy.
Most adverse events (AEs) reported during
olaparib clinical trials conducted in patients with recurrent ovarian
cancer and
measurable disease were of grade 2 or less
severity according to the National Cancer Institute’s Common Terminology
Criteria
for Adverse Events. Fatigue and gastrointestinal
AEs are among the most common in ovarian cancer clinical trials and can
be
particularly bothersome to patients. We focus on
interventions to address these AEs in patients who are candidates for
treatment
with olaparib and allow them to remain on
therapy for as long as clinically indicated.
Implications for Practice:
Olaparib therapy represents a new
approach to treating recurrent ovarian cancer. Some associated adverse
events can have a
substantial effect on quality of life. It is
therefore important for patients, caregivers, and health care providers
to have
realistic expectations and a thorough
understanding of the safety and tolerability profile of olaparib to
prevent or alleviate
key symptoms so that therapy can continue
uninterrupted if possible. This report summarizes a practical approach
to supportive
care for patients receiving olaparib therapy.
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