Should PARP Inhibitors Be Offered to All Women?

How Should Providers Determine When to Prescribe PARP Inhibitors?

• ASCO guidelines now say that PARP inhibitors should be offered to women, with or without genetic mutations, who are newly diagnosed with stage III or IV ovarian cancer and have improved with chemotherapy
• PARP inhibitors should be discussed with all ovarian cancer patients
• With 12 new approvals in the past five years, there are still significant nuances around which patients should get these drugs

Many patients may end up asking about PARP inhibitors. When it comes to these drugs, Dr. Rebecca Arend of the University of Alabama says, “The message is not that each patient should get a PARP inhibitor no matter what, but that it is an awareness that we need to put out into the community.”

There is a hope that more women will ask about their options. It is something that should be discussed with all ovarian cancer patients.

Timing is of consideration, says Dr. Arend. “When is the appropriate time to discuss,” should be considered. Dr. Thomas Herzog notes there have been 12 new approvals in the past five years. PARP inhibitors have transformed the treatment landscape significantly. “Everyone should be counseled about PARPs as a maintenance option,” says Dr. Herzog.

Those that have a mutation are going to benefit more than those that do not. “We still need to do a better job of understanding who benefits and who doesn’t.”

Dr. Dana Chase highlights the need for consideration of a variety factors before considering PARP inhibitors; factors including: how old the patient is, do they work, do they take care of children, etc. Also, consider toxicity and expectations for remission. Informed decision-making is critical.

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