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PARP Inhibitor Therapy with Olaparib: Targeted DNA Repair Inhibition

Synthetic lethality approach exploiting BRCA mutation status and homologous recombination deficiency

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Onkoloji department. Book Appointment →

What is PARP Inhibitor Therapy with Olaparib: Targeted DNA Repair Inhibition?

PARP inhibition impairs single-strand DNA break repair leading to double-strand breaks that cannot be repaired in homologous recombination deficient tumors.

Approved indications include BRCA-mutant or HRD-positive ovarian cancer maintenance, BRCA-mutant breast cancer adjuvant and metastatic settings, BRCA-mutant or HRR-mutant prostate cancer and pancreatic cancer.

Patient selection requires germline and/or somatic BRCA testing with consideration of homologous recombination deficiency assays.

Standard dosing administered orally twice daily with treatment continued until progression or unacceptable toxicity.

Combinations with bevacizumab in ovarian cancer maintenance and with abiraterone in prostate cancer expand applicability.

Symptoms

Common adverse events include nausea, vomiting, fatigue, anemia, decreased appetite and headache.
Hematologic toxicities including anemia, neutropenia and thrombocytopenia are particularly relevant requiring monitoring.
Less common but serious events include myelodysplastic syndrome and acute myeloid leukemia in long-term treatment.
Pneumonitis is rare but potentially serious adverse event requiring prompt evaluation of respiratory symptoms.
Renal function changes, dyspepsia, dysgeusia and dermatologic effects may occur.

Risk Factors

Prior platinum-based chemotherapy with cumulative myelotoxicity may affect tolerability.
Pre-existing cytopenias require dose modification and increased monitoring.
Renal or hepatic dysfunction may require dose adjustment.
Prior or concurrent radiation therapy may increase risk of pneumonitis.
Pregnancy and breastfeeding due to teratogenic potential.

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent fatigue, dyspnea, easy bruising or bleeding require evaluation for cytopenias.
  • New respiratory symptoms including cough, dyspnea or fever require evaluation for pneumonitis.
  • Persistent nausea or vomiting requires symptomatic management and possibly dose modification.
  • Symptoms suggestive of secondary malignancies (unusual bruising, persistent fatigue, fever) require hematologic evaluation.
  • Severe adverse events may require treatment interruption, dose reduction or discontinuation based on grade.

Treatment Methods

01
Comprehensive baseline evaluation including complete blood count, renal function, hepatic function and biomarker testing.
02
Routine monitoring with monthly complete blood counts particularly during initial treatment phase.
03
Symptomatic management of nausea with antiemetic prophylaxis often required.
04
Dose modification, treatment interruption and supportive care guided by toxicity grade.
05
Multidisciplinary care with oncology, hematology and relevant specialty along with consideration of treatment duration, response monitoring with imaging and tumor markers, management of resistance development and integration with sequential therapy strategies optimizes outcomes with this transformative targeted therapy.

Which Department to Visit?

You can visit our Onkoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.