Dr. Backes on Toxicity Considerations With PARP Inhibitors in Ovarian Cancer

Floor J. Backes, MD, associate professor, Division of Gynecologic Oncology, and vice chair, Cancer Institutional Review Board, The Ohio State University Comprehensive Cancer Center—James, discusses toxicity considerations with PARP inhibitors in ovarian cancer.

Currently, the PARP inhibitors olaparib (Lynparza), niraparib (Zejula) and rucaparib (Rubraca) are approved for use in the treatment of patients with ovarian cancer.

All of the agents have similar rates of fatigue and nausea, says Backes. The biggest differences among these agents are with regard to hematologic adverse events (AEs). For example, known AEs with niraparib are anemia, thrombocytopenia, and neutropenia. However, because niraparib is administered once daily, it may be a preferred agent for patients who struggle with taking medication multiple times per day, explains Backes.

Additionally, niraparib may increase blood pressure, so an alternative agent should be used in patients who have issues managing their blood pressure. Rucaparib can raise cholesterol, so this agent should be avoided in patients who already have high cholesterol, concludes Backes.