PARP Inhibitors for Ovarian Cancer: The Side Effects
- The most common side effects of 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 these drugs and the side effects can subside, or become easier to tolerate.
PARP inhibitors have begun to alter the treatment landscape for women with ovarian cancer. Though they’re shown to be most effective for patients with BRCA mutations, the pool of candidates for these drugs have expanded to the point where almost all women diagnosed with ovarian cancer are now eligible to receive a PARP inhibitor at some time during their treatment.
Most recently, 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 can be well tolerated, they can have 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, the side effects for all three tend to be similar.
“The first month on a PARP inhibitor can be hard for patients,” says Dr. Melissa Geller, gynecologic oncologist at the University of Minnesota. “Nausea is a big issue. We tell patients to let us know if they’re very nauseated, if it’s become a problem, so we can give them anti-nausea medicines to take 30 minutes before taking their PARP medication. That tends to help.”
In some cases Geller says she will prescribe the PARP medication for patients to take before going to bed. “Once they go to sleep they’re really not experiencing the nausea as much. So there are different ways we can play with the medication a little bit to help get rid of that nausea.”
Another common complaint that Geller hears is that patients are often very fatigued. Some of that, she says, can be due to low hemoglobin levels. “We watch that very carefully. Most of our patients who are on PARP inhibitors get blood testing every month. Even if we don’t bring them in to be seen, we’re still monitoring their blood levels. Occasionally, a patient may require a transfusion, though that’s pretty rare.”
When doctors do see counts start to drop, they might reduce the dosage of the PARP inhibitors to help alleviate the anemia and the fatigue. “Most patients see an improvement once we make that dose adjustment,” Geller says, though occasionally doctors may have to switch to a different PARP inhibitor for a patient to feel noticeably better.
“After that first month, most patients, for whatever reason, start to get used to the medication and do much better on it.” The fatigue especially tends to pass, or else it’s lessened to where it’s no longer an issue.
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.”
Learn more about SurvivorNet's rigorous medical review process.
Dr. Melissa Geller is a gynecologic oncologist at the University of Minnesota. Read More
PARP Inhibitors for Ovarian Cancer: The Side Effects
- The most common side effects of 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 these drugs and the side effects can subside, or become easier to tolerate.
PARP inhibitors have begun to alter the treatment landscape for women with ovarian cancer. Though they’re shown to be most effective for patients with BRCA mutations, the pool of candidates for these drugs have expanded to the point where almost all women diagnosed with ovarian cancer are now eligible to receive a PARP inhibitor at some time during their treatment.
Most recently, 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.
Read More
And while these game changing drugs can be well tolerated, they can have 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, the side effects for all three tend to be similar.
“The first month on a PARP inhibitor can be hard for patients,” says Dr. Melissa Geller, gynecologic oncologist at the University of Minnesota. “Nausea is a big issue. We tell patients to let us know if they’re very nauseated, if it’s become a problem, so we can give them anti-nausea medicines to take 30 minutes before taking their PARP medication. That tends to help.”
In some cases Geller says she will prescribe the PARP medication for patients to take before going to bed. “Once they go to sleep they’re really not experiencing the nausea as much. So there are different ways we can play with the medication a little bit to help get rid of that nausea.”
Another common complaint that Geller hears is that patients are often very fatigued. Some of that, she says, can be due to low hemoglobin levels. “We watch that very carefully. Most of our patients who are on PARP inhibitors get blood testing every month. Even if we don’t bring them in to be seen, we’re still monitoring their blood levels. Occasionally, a patient may require a transfusion, though that’s pretty rare.”
When doctors do see counts start to drop, they might reduce the dosage of the PARP inhibitors to help alleviate the anemia and the fatigue. “Most patients see an improvement once we make that dose adjustment,” Geller says, though occasionally doctors may have to switch to a different PARP inhibitor for a patient to feel noticeably better.
“After that first month, most patients, for whatever reason, start to get used to the medication and do much better on it.” The fatigue especially tends to pass, or else it’s lessened to where it’s no longer an issue.
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.”
Learn more about SurvivorNet's rigorous medical review process.
Dr. Melissa Geller is a gynecologic oncologist at the University of Minnesota. Read More
