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

• Main Authors: Laura Tookman, Jonathan Krell, Baleseng Nkolobe, Laura Burley, Iain A. McNeish
• Format: Article
• Language: English
• Published: SAGE Publishing 2020-05-01
• Series: Therapeutic Advances in Medical Oncology
• Online Access: https://doi.org/10.1177/1758835920921980

The use of targeted therapeutics known as poly(adenosine diphosphate–ribose) polymerase (PARP) inhibitors in the management of ovarian cancer is currently transforming clinical practice. The PARP inhibitor rucaparib is indicated in the UK, European Union and the United States for use in the treatment and maintenance settings for patients with relapsed ovarian cancer. Here, we discuss some of the real-world challenges and side effects that we have encountered while prescribing rucaparib, and we provide practical guidance on how the individual members of our multidisciplinary team (MDT), including a clinician, chemotherapy nurse practitioner, and clinical pharmacist, collaborate to manage these side effects. If recognized early, the side effects experienced by patients 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, and early detection of decreases in hemoglobin levels allows for proactive interventions to alleviate anemia. The MDT should work together with the patient to identify potential side effects early and manage them effectively. The aim of this proactive approach is to maintain patients on rucaparib for optimal clinical benefit, while minimizing the potential negative impact of side effects on patient quality of life.