PARP Inhibitors -- Which Drug is Best?
- PARP inhibitors are an effective treatment option for most women with ovarian cancer
- The drugs work by preventing ovarian cancer cells from repairing damaged DNA
- The three FDA-approved PARP inhibitors are olaparib, niraparib, and rucaparib
- Choosing the right PARP inhibitor for your specific treatment may involve weighing the side effect profiles and considering the timing at which you would be receiving the drug
There are currently three different types of PARP inhibitors available to women with ovarian cancer, though Dr. Helen Eshed,
a gynecologic oncologist at Texas Oncology in Austin, says there may even be more at this point. The three main PARP inhibitor drugs Zejula (niraparib), Lynparza (olaparib), and Rubraca (rucaparib) do differ slightly from one another, but they all work more or less the same way in that they prevent cancer cells from naturally repairing the DNA that's been damaged during the course of ovarian cancer treatment.
PARP inhibitors specifically work by blocking a protein that helps cancer cells repair their damaged DNA. The drugs, according to Dr. Eshed, are generally very well tolerated among women with ovarian cancer, even those who are frail. Read More
“PARP inhibitors… tend to be tolerated whether you’re young, healthy, and strong or older, weaker,” she says. In choosing which PARP inhibitor is best for a specific woman with ovarian cancer, Dr. Eshed says she tends to consider the drugs’ side effect profile as well as the specific “indication” of the drug. By indication, she means the specific setting for which the drug is approved. Certain PARP inhibitors, for instance, are currently approved to be used at different points in a treatment journey, such as “up-front,” meaning from the very beginning of treatment, or as “maintenance,” meaning after a patient has already received treatment and is looking to keep her cancer from coming back (that is, repairing itself and continuing to spread). Almost all patients with ovarian cancer are eligible to receive PARP inhibitors in some capacity, regardless of whether they have a BRCA mutation in their ovarian cancer, says Dr. Eshed. Previously, it was thought that PARP inhibitors were only effective when someone had this genetic mutation, but recent trials have shown that almost all patients can benefit, greatly expanding the pool of women for whom these drugs are an option. In fact, the American Society of Clinical Oncology (ASCO) released 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.
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