Expert: Pharmacists Should Be Aware of Indications for Various Types of Ovarian Cancer

Clinical oncology pharmacist Amy Indorf, PharmD, BCOP, discusses her presentation on the role of PARP inhibitors for ovarian cancer.

In an interview with Pharmacy Times at the American Society of Health-Systems Pharmacy 2022 Midyear Clinical Meeting, clinical oncology pharmacist Amy Indorf, PharmD, BCOP, discussed her presentation on the role of PARP inhibitors for ovarian cancer.

Q: What is the current treatment protocol for ovarian cancer and what is the role of PARP inhibitors within that protocol?

Amy Indorf, PharmD, BCOP: You know, our platinum doublet carbo-taxol is still our current go-to. And then the newest therapies (new being relative) is the PARP inhibitors. PARP inhibitors are standard first-line therapy for those with the actionable mutations. And then this presentation will kind of dive into the nuances of where patients should be getting PARP inhibitors, what adverse effects to look out for, patient selection criteria, and if other options are more appropriate.

Q: What considerations go into determining when the use of PARP inhibitors is appropriate within the treatment timeline?

Amy Indorf, PharmD, BCOP: The considerations that go into determining when the use of a PARP inhibitor is appropriate is dependent on their genetic marker testing [and] their biomarker testing. So, whether or not they're germline or somatic, BRCA mutated or wild type. And then in the recurrent setting, what other biomarkers they have that might determine other treatment options. We want to make sure also that they have a response to our platinum doublet therapies.

Q: What are currently approved PARP inhibitors for this patient population and how have they changed the treatment landscape?

Amy Indorf, PharmD, BCOP: So, the currently approved PARP inhibitors are still olaparib, rucaparib, and niraparib—that really hasn't changed in the last couple years. What continues to evolve is what they can be used in combination with. So, VEGF inhibitors, immunotherapy—these are ongoing trials that I think are going to change the landscape, although we're still waiting on confirmatory data and learning more about evolving clinical trials. What has changed is the voluntary withdrawal of the indications for all 3 of these agents—olaparib, rucaparib, and niraparib—in the recurrent setting [Note: niraparib was only withdrawn in the non-BRCA recurrent setting].

Q: Are there any key efficacy data that you highlight in your presentation?

Amy Indorf, PharmD, BCOP: So, my co-presenters are going to highlight key efficacy data, most of my participation will be within the panel. And so, I'm excited to hear what my presenters have to say about the key efficacy data. Again, the big highlight is the voluntary withdrawal of the indications for all 3 agents in the recurrent setting.

Q: What should pharmacists be aware of when treating patients with PARP inhibitors, particularly with regard to adverse effects?

Amy Indorf, PharmD, BCOP: I think that the key thing is the adverse effects. These agents have been out for a couple years and we're learning more about how patients continue to do their daily activities while on these agents, how they respond to these agents in terms of side effects, both in the short-term and long-term, because these are agents that patients will be on for years.

Q: What should pharmacists be aware of when treating patients with PARP inhibitors, particularly with regard to adverse effects?

Amy Indorf, PharmD, BCOP: So, understanding their baseline comorbidities and then selecting the right drug based on that profile, I think is really key to selecting the right treatment for these patients. Additionally, as a pharmacist, I think it's important to be aware of these indications forsomatic versus germline,BRCA mutated or wild type patients, because this I think will continue to change.

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