AN OVERVIEW OF PARP INHIBITORS IN BRCA 1/2 MUTATED OVARIAN CANCER

Ovarian cancer being asymptomatic is leading to late diagnosis resulting in increased death rate worldwide. The development of platinum resistant ovarian cancer, research has paved the way for new class of drug called PARP inhibitors. PARP inhibitors [Poly (ADP-Ribose) polymerase inhibitors] are used in epithelial cell carcinoma, platinum resistant ovarian cancer, recurrent ovarian cancer etc. They act by inhibiting PARP proteins that are involved in DNA repair, finally resulting in cell death. Olaparib, Niraparib, Rucaparib, Talazoparib and Veliparib are the members that belong to the family of PARP inhibitors. These drugs vary in their route of administration, dose, toxicity profile, efficacy and pharmacokinetic parameters. This class of drugs majorly exhibits haematological and gastrointestinal adverse reactions. Most of these drugs causes Myelodysplastic syndrome/ Acute Myeloid Leukaemia and Embryo-foetal toxicity. These classes of drugs are contraindicated in lactating women, also these drugs shows wide changes in various laboratory parameters. Pharmacist plays a major role in monitoring the patient’s laboratory values, thereby modifying the dose of the drug in toxicities. The main role of a clinical pharmacist is dose adjustment in renal and hepatic impairment patients. It is also hypothesized that, these drugs exhibit resistance through the efflux of drug by p-gp transporters. Another concern with this class of drugs is development of secondary malignancy. This review summarizes the characteristics and uses of various drugs that belongs to PARP inhibitors.

KEYWORDS: Ovarian cancer, Epithelial cell carcinoma, PARP Inhibitors, Olaparib, Niraparib, Rucaparib.