1. Sharing real-world experiences to optimize the management of olaparib toxicities: a practical guidance from an Italian expert panel
- Author
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Giulia Tasca, Clelia Casartelli, Giusy Scandurra, Valentina Guarneri, Claudia Marchetti, Elena Maccaroni, Rocco De Vivo, Claudio Zamagni, Emanuele Baldo Gisone, Emanuele Naglieri, Marilena Di Napoli, Giovanna Scarfone, Vera Loizzi, Ilaria Spagnoletti, Vanda Salutari, Veronica Parolin, Giorgia Mangili, Fabrizio Artioli, G. Ronzino, Germana Tognon, Francesca Martella, Domenica Lorusso, Giusy Ricciardi, Elisabetta De Matteis, Valentina Arcangeli, Rossella Lauria, Cinzia Cardalesi, Sabrina Chiara Cecere, Mariangela Bella, Alberto Andrea Lissoni, Alessandra Bologna, Simona Secondino, Giusi Blanco, Lorusso, D, Bologna, A, Cecere, S, De Matteis, E, Scandurra, G, Zamagni, C, Arcangeli, V, Artioli, F, Bella, M, Blanco, G, Cardalesi, C, Casartelli, C, De Vivo, R, Di Napoli, M, Gisone, E, Lauria, R, Lissoni, A, Loizzi, V, Maccaroni, E, Mangili, G, Marchetti, C, Martella, F, Naglieri, E, Parolin, V, Ricciardi, G, Ronzino, G, Salutari, V, Scarfone, G, Secondino, S, Spagnoletti, I, Tasca, G, Tognon, G, and Guarneri, V
- Subjects
Psychological intervention ,Clinical practice ,Piperazines ,Poly(ADP-ribose) Polymerase Inhibitor ,Antineoplastic Agent ,chemistry.chemical_compound ,0302 clinical medicine ,Olaparib ,Maintenance therapy ,030212 general & internal medicine ,Fatigue ,Phthalazine ,Ovarian Neoplasms ,BRCA1 Protein ,Nursing research ,Adherence ,Recurrent ovarian cancer ,Toxicities ,Transition ,Anemia ,Antineoplastic Agents ,BRCA2 Protein ,Female ,Humans ,Italy ,Mutation ,Nausea ,Neoplasm Recurrence, Local ,Phthalazines ,Poly(ADP-ribose) Polymerase Inhibitors ,Vomiting ,Local ,Oncology ,030220 oncology & carcinogenesis ,medicine.symptom ,Human ,medicine.medical_specialty ,Psycho-oncology ,03 medical and health sciences ,medicine ,Intensive care medicine ,Piperazine ,Settore MED/06 - ONCOLOGIA MEDICA ,business.industry ,Ovarian Neoplasm ,BRCA mutation ,Neoplasm Recurrence ,Settore MED/40 - GINECOLOGIA E OSTETRICIA ,Toxicitie ,chemistry ,business - Abstract
Olaparib is the first poly(ADP-ribose) polymerase inhibitor approved as maintenance therapy of recurrent ovarian cancer (OC) patients with a BRCA mutation. To achieve the maximum clinical benefit, adherence to olaparib must be persistent. However, in clinical practice, this is challenged by the frequent suboptimal management of toxicities. In view of the expanding use of olaparib also in Italy, physicians must learn how to adequately and promptly manage drug toxicities not to unnecessarily interrupt or reduce the dose. The experts agreed that nausea,vomiting, anemia, and fatigue are the most frequent events experienced by OC patients on olaparib, and that these toxicities usually develop early during treatment, are mainly of grade 1-2 and transient and can be managed with simple non-pharmacological interventions. By sharing their real-world experiences, the panel prepared, for each toxicity, an algorithm organized by grade and besides the procedures indicated in the local label, included supportive care interventions based also on nutritional and lifestyle modifications and psycho-oncology consultation. Moreover, in view of the tablet entry into the Italian market, the full and reduced dosages of capsules and tablets were compared. This practical guidance is intended to be a tool to support especially less-experienced physicians in the management of these complex patients, with the aim to help preventing the worsening of patients' conditions and the unnecessary interruption/reduction of olaparib dosage, which may jeopardize treatment efficacy.
- Published
- 2020