PARP Inhibitors for Ovarian Cancer -- Side Effects
- The most common side effects from PARP inhibitors are nausea, vomiting, and fatigue
- Reducing the dosage can lessen side effects without impacting efficacy if needed
- After the first month, many patients will adapt to the drug and the side effects subside, or become easier to tolerate
PARP inhibitors have altered the treatment landscape for women with ovarian cancer. These drugs are available to almost all women, though women with BRCA gene mutations or who are HRD proficient may benefit the most from them. 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.
And while these game changing drugs are generally well-tolerated, they are not without side effects. There are currently three types of PARP inhibitors approved for women with ovarian cancer, and while the dosing may vary depending on which medication a woman is on, all three types do tend to have similar side effects.
Read More Dr. Rabbie Hanna, a gynecologic oncologist at the Henry Ford Health System, spoke to SurvivorNet about the quality of life in patients receiving PARP inhibitors, explaining that because PARP inhibitors are pills, patients do not have to travel to infusion centers. This means reduced visits to hospital settings. PARP inhibitors result in two classes of side effects, namely non-hematological and hematological side effects. The non-hematological side effects include fatigue, nausea, vomiting and gastrointestinal disturbances, and insomnia. The hematological side effects include reductions in white blood cell count, red blood cell count, and platelet count. Doctors tend to monitor these side effects for the first month or two in patients to determine how to adjust the dosing so that the side effects are alleviated.
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."
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