What’s it Like to Take a PARP Inhibitor?

According to Dr. Arend, women are likely to experience some initial side effects in the first few months after treatment, including:

• Nausea
• Stomach Cramps
• Fatigue, which is typically the most severe symptom
• Bone marrow suppression (a decrease in bone marrow activity that results in reduced production of blood cells)

If women can get through the first two months of treatment, however, these side effects typically subside, says Dr. Arend.

“What we’ve found is that if you can get through the first two months of being on maintenance therapy … then you actually start to feel better,” says Dr. Arend. Physicians aren’t clear on exactly why this improvement generally occurs.

According to Dr. Arend, “we don’t know for sure is it that women are becoming more used to it as their sort of (sic) pace of living? Or is it that their fatigue really goes away?” In any case, women typically start feeling better after two months.

Other possible sides effects that are less common include hypertension, heart palpitations and bone marrow suppression.

Patients should take into account multiple factors when deciding on which PARP inhibitor to choose, says Dr. Arend, as there aren’t hard and fast rules. These factors include:

• Insurance coverage: Which drug does your insurance cover the most? Which is best for your financial situation?
• Disease progression: One drug may be best for you depending on the stage of your cancer treatment.
• Sensitivity to platinum-based chemo: Have you responded well to chemotherapy? That can help determine which inhibitor may be best for you.

PARP inhibitors are now available to almost all women, though women with BRCA gene mutations or whose tumors have HRD (a measure of how well their cancer cell DNA replicates) 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.

Dr. Arend makes clear that all three PARP inhibitors have side effects (similar with some important variations), so a decision will come down to a conversation with your personal doctor.

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