PARP Inhibitors for Ovarian Cancer during COVID-19 Pandemic
- Limiting personal contact is crucial during the pandemic.
- PARP inhibitors help fight ovarian cancer at a genetic level.
- PARP inhibitors are oral pills that can be prescribed electronically.
- Oncologists say at least some in person time with your doctor is crucial because nothing can replace being in the room to help communicate how you’re really doing and what you’re feeling.
Doctors have responded to the COVID-19 crisis with some new tactics in their approach to ovarian cancer treatment, using telemedicine, electronic prescription management.
Oral PARP inhibitor drugs are becoming a huge part of the treatment plan for a growing number of women. These 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.
PARPs For Newly Diagnosed Ovarian Cancer
The PARP inhibitor Zejula (niraparib) has been approved by the FDA for all women with newly diagnosed ovarian cancer irrespective of their genetics. The drug is used after successful treatment with a platinum-based chemotherapy, the mainstay chemotherapy for ovarian cancer.
While PARP inhibitors are now available to almost all women, women with BRCA gene mutations or whose tumors have a genetic factor called HRD may benefit the most from these drugs. (HRD means that a woman’s ovarian cancer cells have trouble repairing themselves. And this can make them somewhat easier to fight.)
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 shown some improvement with chemotherapy.
Still, Dr. Amanika Kumar of the Mayo Clinic who spoke to SurvivorNet, cautions 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.”
The PARP inhibitor Lynparza (olaparib) is approved for women newly diagnosed with ovarian cancer and with a germline or somatic mutation in BRCA1/2.
Lynparza is also approved in combination with Avastin (bevacizumab) for women with HRD. Avastin is a blood vessel growth inhibitor, which works by starving the tumor of vital nutrients needed to grow.
Using PARPs to Treat Recurrence
Unfortunately, too often, ovarian cancer comes back.
For women with ovarian cancer who have had a recurrence and responded to platinum-based chemotherapy, Lynparza, Zejula and another PARP inhibitor called Rubraca (rucaparib) are FDA approved for use as a maintenance therapy, regardless of whether a woman has a BRCA mutation or HRD.
For some women who have had prior chemotherapy treatments, Rubraca, Zejula or Lynparza may also be options. These uses are based on factors such as number of prior therapies and BRCA mutation or HRD.
The different PARP inhibitors do have some varying side effects, which oncologists need to evaluate carefully.
Options to Reduce Risk of COVID-19 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.
Dr. Lee-may Chen is a gynecologic cancer surgeon at UCSF Health. Read More
PARP Inhibitors for Ovarian Cancer during COVID-19 Pandemic
- Limiting personal contact is crucial during the pandemic.
- PARP inhibitors help fight ovarian cancer at a genetic level.
- PARP inhibitors are oral pills that can be prescribed electronically.
- Oncologists say at least some in person time with your doctor is crucial because nothing can replace being in the room to help communicate how you’re really doing and what you’re feeling.
Doctors have responded to the COVID-19 crisis with some
new tactics in their approach to ovarian cancer treatment, using telemedicine, electronic prescription management.
Oral PARP inhibitor drugs are becoming a huge part of the treatment plan for a growing number of women. These can be taken at home, says Dr. Lee-May Chen, a gynecologic oncologist at the University of California San Francisco Cancer Center.
Read More “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.
PARPs For Newly Diagnosed Ovarian Cancer
The PARP inhibitor Zejula (niraparib) has been approved by the FDA for all women with newly diagnosed ovarian cancer irrespective of their genetics. The drug is used after successful treatment with a platinum-based chemotherapy, the mainstay chemotherapy for ovarian cancer.
While PARP inhibitors are now available to almost all women, women with BRCA gene mutations or whose tumors have a genetic factor called HRD may benefit the most from these drugs. (HRD means that a woman’s ovarian cancer cells have trouble repairing themselves. And this can make them somewhat easier to fight.)
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 shown some improvement with chemotherapy.
Still, Dr. Amanika Kumar of the Mayo Clinic who spoke to SurvivorNet, cautions 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.”
The PARP inhibitor Lynparza (olaparib) is approved for women newly diagnosed with ovarian cancer and with a germline or somatic mutation in BRCA1/2.
Lynparza is also approved in combination with Avastin (bevacizumab) for women with HRD. Avastin is a blood vessel growth inhibitor, which works by starving the tumor of vital nutrients needed to grow.
Using PARPs to Treat Recurrence
Unfortunately, too often, ovarian cancer comes back.
For women with ovarian cancer who have had a recurrence and responded to platinum-based chemotherapy, Lynparza, Zejula and another PARP inhibitor called Rubraca (rucaparib) are FDA approved for use as a maintenance therapy, regardless of whether a woman has a BRCA mutation or HRD.
For some women who have had prior chemotherapy treatments, Rubraca, Zejula or Lynparza may also be options. These uses are based on factors such as number of prior therapies and BRCA mutation or HRD.
The different PARP inhibitors do have some varying side effects, which oncologists need to evaluate carefully.
Options to Reduce Risk of COVID-19 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.
Dr. Lee-may Chen is a gynecologic cancer surgeon at UCSF Health. Read More
