Lauren Mahon Offers Nurse Perspectives on PARP Inhibitors As Ovarian Cancer Maintenance Therapy

For this episode of The Vitals, Oncology Nursing News® talks with Lauren Mahon, MSN, FNP-BC, about the role of PARP inhibitors in the treatment of ovarian cancers. Mahon, a family nurse practitioner specializing in gynecologic oncology at the University of Rochester, recently presented on this class of therapeutics during the 48th Annual Oncology Nursing Society Congress.

Onsite at the Congress, Mahon discussed the potential benefit of oral maintenance therapy with PARP inhibitors, the importance of genetic testing in this setting, and the different toxicity profiles associated with these treatments.

Niraparib (Zejula), olaparib (Lynparza), and rucaparib (Rubraca), are approved by the FDA for the treatment of patients with advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer in the maintenance setting.^1-3 Niraparib is approved as a maintenance therapy for adult patients who are in a complete, or partial response to first-line platinum-based chemotherapy. It is also approved as a maintenance treatment for adult patients with deleterious or suspected deleterious germline BRCA-mutated disease who are in a complete or partial response to platinum-based chemotherapy.¹

Olaparib is approved as a maintenance treatment for adult patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer, who are in a complete or partial response to platinum-based chemotherapy; it is also approved as a maintenance treatment for adult patients with deleterious or suspected deleterious germline or somatic BRCA-mutated advanced disease who are in complete or partial response to first-line platinum-based chemotherapy; and it is approved as a maintenance therapy, in combination with bevacizumab (Avastin) for patients with advanced disease who are in complete or partial response to first-line platinum-based chemotherapy and whose cancer is associated with homologous recombination deficiency–positive status defined by either: a deleterious or suspected deleterious BRCA mutation, and/or genomic instability.²

Rucaparib is approved as a maintenance treatment of adult patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer whose disease harbors a deleterious germline or somatic BRCA mutation following either a partial or complete response to platinum-based chemotherapy.³

Although controversy surrounds these drugs in other settings, Mahon explains that they offer patients some peace of mind and freedom in the maintenance setting, as they minimize recurrence risk without forcing patients to come in for regular intravenous (IV) infusions.

“Oral medications, in general, give you more flexibility,” she said. “People have their quality of life back. They’re not tied to an IV every 3 to 4 weeks. They can go and travel they can spend time with their family members.”

Episode Highlights

What I’ve seen throughout my practice is that, once we are done with the IV chemotherapy: patients are saying—what’s next? What else can I do to make sure that I have the highest chance that this does not come back? Time stamp (TS) 1:55

They have hematologic toxicities, but the main PARP inhibitor that causes anemia and thrombocytopenia is niraparib. TS 4:40

Doing that genetic testing both—for themselves and their family members—is really important. TS 6:00

Further Reading:

• Nurses Play Key Role in Facilitating Maintenance Therapy With PARP Inhibitors in Ovarian Cancer
• Olaparib Maintenance Yields Long-Term Remission for Women With BRCA+ Ovarian Cancer
• Post-hoc Analysis Shows Maintenance Niraparib Provides Additional Antitumor Activity in Advanced Ovarian Cancer
• Rucaparib Maintenance Extends Progression-Free Survival in Advanced Ovarian Cancer
• Real-World Data Identify Significant Differences in Tolerability Among Approved PARP Inhibitors in Ovarian Cancer

Video Interviews:

• Paula Anastasia Emphasizes Importance of Genetic Testing in Selecting Maintenance Therapy for Ovarian Cancer
• Expert Weighs In On The Future of PARP Inhibitors

Additional The Vitals Podcasts:

• Bringing a New Approach to Symptom Management in Ovarian Cancer
• A Look Back at 2022 FDA Approvals in Oncology

References

1. Zejula. Prescribing information. GlaxoSmithKline; 2020. Accessed June 6, 2023. https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/208447s015s017lbledt.pdf
2. Lynparza. Prescribing information. AstraZeneza; 2023. Accessed June 6, 2023. https://den8dhaj6zs0e.cloudfront.net/50fd68b9-106b-4550-b5d0-12b045f8b184/00997c3f-5912-486f-a7db-930b4639cd51/00997c3f-5912-486f-a7db-930b4639cd51_viewable_rendition__v.pdf
3. Rubraca. Clovis oncology, Inc; 2022. Accessed June 6, 2023. https://clovisoncology.com/pdfs/RubracaUSPI.pdf