Manage wisely: poly (ADP-ribose) polymerase inhibitor (PARPi) treatment and adverse events

被引:63
作者
Madariaga, Ainhoa [1 ]
Bowering, Valerie [1 ]
Ahrari, Soha [2 ]
Oza, Amit M. [1 ]
Lheureux, Stephanie [1 ]
机构
[1] Princess Margaret Hosp Canc Ctr, Med Oncol & Hematol, Toronto, ON M5G 2C, Canada
[2] Princess Margaret Hosp Canc Ctr, Pharm, Toronto, ON, Canada
关键词
ovarian cancer; GRADE OVARIAN-CARCINOMA; MAINTENANCE THERAPY; OPEN-LABEL; DOUBLE-BLIND; DNA-REPAIR; PHASE-II; OLAPARIB; CANCER; RUCAPARIB; GERMLINE;
D O I
10.1136/ijgc-2020-001288
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Poly (ADP-ribose) polymerase (PARP) inhibitors (PARPi) have transformed the treatment landscape in front-line and recurrent high-grade serous ovarian cancer. Maintenance strategies with PARPi have been assessed in randomized phase III trials in ovarian cancer; switch maintenance in the case of olaparib, niraparib, and rucaparib; and concurrent followed by continuation maintenance with veliparib. These studies have shown progression-free survival advantage with PARPi maintenance, with no major adverse changes in the quality of life; however, overall survival data remain immature to date. PARPi have also been incorporated in clinical practice as a single-agent treatment strategy in high-grade serous ovarian cancer, mainly in women who harbor alterations in theBRCA1/2genes or have alterations in the homologous recombination deficiency (HRD) pathway. Contemporary studies are looking into potentially synergistic combination strategies with anti-angiogenics and immune checkpoint inhibitors, among others. The expansion of PARPi treatment has not been limited to ovarian cancer; talazoparib is licensed in patients with HER2-negative breast cancer with germlineBRCAmutations (BRCAm), and front-line olaparib maintenance in patients with pancreatic cancer with germlineBRCAm. Numerous studies assessing PARPi either in monotherapy or in combination with other agents are ongoing in multiple tumors, including prostate, endometrial, brain, and gastric cancers. Many patients are being treated with PARPi, some for prolonged periods of time. As a result, a thorough knowledge of the potential short- and long-term adverse events and their management is warranted to improve patient safety, treatment efficacy, and towards maintaining an appropriate dose intensity.
引用
收藏
页码:903 / 915
页数:13
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