Practical guidance for the management of side effects duringrucaparib therapy in a multidisciplinary UK setting

摘要

The use of targeted therapeutics known as poly(adenosine diphosphate–ribose)polymerase (PARP) inhibitors in the management of ovarian cancer is currentlytransforming clinical practice. The PARP inhibitor rucaparib is indicated in theUK, European Union and the United States for use in the treatment andmaintenance settings for patients with relapsed ovarian cancer. Here, we discusssome of the real-world challenges and side effects that we have encounteredwhile prescribing rucaparib, and we provide practical guidance on how theindividual members of our multidisciplinary team (MDT), including a clinician,chemotherapy nurse practitioner, and clinical pharmacist, collaborate to managethese side effects. If recognized early, the side effects experienced bypatients during rucaparib therapy, which include fatigue, nausea and vomiting,liver enzyme elevations, and anemia, can be easily managed. For example,providing patients with prophylactic antiemetics can help them avoid nausea, andearly detection of decreases in hemoglobin levels allows for proactiveinterventions to alleviate anemia. The MDT should work together with the patientto identify potential side effects early and manage them effectively. The aim ofthis proactive approach is to maintain patients on rucaparib for optimalclinical benefit, while minimizing the potential negative impact of side effectson patient quality of life.