Paula Anastasia on PARP Inhibitor Ineligibility Factors for Women With Ovarian Cancer

Most patients are fit to receive a PARP inhibitor for the treatment of ovarian cancer, according to Paula Anastasia, RN, MN, AOCN; however, certain patients may need to start on a lower dose.

Anastasia, a gynecologic oncology clinical nurse specialist for UCLA Health, recently presented on PARP inhibition nursing considerations as part of the 6th Annual School of Nursing Oncology® Meeting. In an interview with Oncology Nursing News®, Anastasia discussed the circumstances in which a patient may not be fit for PARP inhibition, even if it was standard of care.

Patients who have poor performance status, for example, or other comorbidities may require an adjusted dosage. However, it is important to note that lower doses do not translate to sub therapeutic benefit.

Other important considerations include individual adverse event profiles, chemotherapy responses, and whether a patient is able to adhere to the administration guidelines, as these are oral medications.

Anastasia also illuminates the fact that, for many patients, the price of these therapies represents a major barrier to care. “These medications can be very expensive, and I’ve [seen] copays of $0 and I’ve [seen] copays of $5000 to $10,000,” she said.

According to Anastasia, ineligibility because of financial burden is not talked about in regard to PARP inhibitors, and although there are copay assistance programs, they are largely underutilized. She notes that she has been successful in obtaining grants for her patients and that leveraging pharmaceutical companies can be helpful.

“It can sometimes be time consuming, but the copay assistance programs, and access groups will do some of the legwork for us.”