Dr. Pothuri on Treatment Considerations for PARP Inhibitors in Ovarian Cancer

Bhavana Pothuri, MD, a professor in the Department of Obstetrics and Gynecology at NYU School of Medicine, and director of gynecologic oncology clinical trials at NYU Langone Health’s Perlmutter Cancer Center, discusses treatment considerations for PARP inhibitors in patients with ovarian cancer.

From an efficacy standpoint, all the PARP inhibitors that have been FDA approved for the treatment of this patient population are similar, according to Pothuri. However, some differences exist with regard to dosing schedule. For example, olaparib (Lynparza) and rucaparib (Rubraca) are given twice daily, and niraparib (Zejula) is given once daily. The dosing schedule is something to consider if patient compliance is an issue, Pothuri says.

Additionally, certain agents will impact the SIP metabolism, so it is important to understand drug–drug interactions when choosing a treatment regimen, Pothuri notes. Moreover, in patients with significant myelosuppression, niraparib has been shown to result in significant thrombocytopenia, especially in studies that did not utilize the individualized dosing where a 200-mL dose is given to those who are less than 77 kg, or have a platelet count of less than 150,000 per mL, Pothuri adds.

It is important to keep these factors in mind when utilizing PARP inhibitors, Pothuri says. Additionally, letting the bone marrow recover after completing frontline chemotherapy is needed to improve the tolerability of these agents, Pothuri concludes.