PARP Inhibitors for Ovarian Cancer during COVID-19 Pandemic

Doctors have responded to the COVID-19 crisis with strategic updates to their approach to ovarian cancer treatment, using telemedicine, electronic prescription management, and oral PARP inhibitor drugs, which can be taken at home, says Dr. Lee-May Chen, a gynecologic oncologist at the University of California San Francisco Cancer Center.

“PARP inhibitors are an oral class of treatment that we use in ovarian cancer,” says Dr. Chen. They provide targeted therapy to help fight ovarian cancer at the genetic level.  “Because they’re given orally, we are able to continue this treatment during the COVID-19 pandemic,” she explains.

PARP Inhibitor Drugs: Taken At Home

PARP inhibitors can be prescribed electronically and delivered directly to patients at home. From there, patients can take the medication and schedule follow-up visits with their doctors on video-conferencing calls to monitor side-effects and discuss dose adjustments.

“By doing video visits for your care and having fewer encounters at the Cancer Center itself, our hope is that you stay at home more. You have less risk of exposure, but we are continuing to support you,” Dr. Chen explains.

Women with a BRCA-1 or BRCA-2 genetic mutation had been shown to respond especially well to PARP inhibitors after recurrence. The Food and Drug Administration has recently approved niraparib (brand name ZEJULA) for almost all women regardless of whether they have the BRCA mutation, as part of an initial course of treatment, or what’s called front-line treatment.   This is especially good news during COVID-19.

While PARP inhibitors are now 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) released new guidelines recommending 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.

However, Dr. Amanika Kumar of the Mayo Clinic who spoke to SurvivorNet, cautioned that women still need to speak with their doctor to evaluate the benefit of taking a PARP inhibitor to extend life, because there are very real side effects due to the toxicity of the drug. “Patients with HRD (homologous recombination deficiency) have a far better response than those without and those with BRCA mutations even more so. It is on us as clinicians to help patients understand the risks and benefits of treatment. Patients that have no mutation or HRD may choose not to go on maintenance (in fact I recommend they don’t) because there is real toxicity to these meds.”

Options To Reduce Risk of Exposure

Dr. Chen says patients still have the option to come in for an office appointment when necessary: “We would talk to you about symptoms. If there’s a need for you to come into the office to see me, we would schedule an appointment where you would be screened before coming in.”

She continues, “But if you’re feeling alright, we would also be able to continue our video visits, and have your prescriptions refilled electronically through your specialty pharmacy, though you would still need to get labs drawn so we can monitor any side effects or toxicities.”

Learn more about SurvivorNet's rigorous medical review process.