New Role of Olaparib on the Treatment of Epithelial Ovarian Cancer
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Abstract
Epithelial ovarian cancer is one of the most common types of ovarian cancer. This treatment consists of surgery and chemotherapy depending on the stage of the disease. Primary chemotherapy regimen consists of platinum as the main drug in combination with other chemotherapeutics. However, some patients may fail from this therapy. Poly (adenosine diphosphate [ADP] -ribose) polymerase (PARP) inhibitors, olaparib, inhibits the DNA repair process of cancer cells and induces apoptosis of cancer cells with breast cancer type 1 susceptibility protein (BRCA1) or BRCA2 mutation (BRCA1/2 mutation). Indication of this drug is the treatment of epithelial ovarian cancer with BRCA mutation or with failure of more than 3 or more chemotherapy regimens. The dose of olaparib is 400 mg twice a day for the capsule, and 300 mg twice daily for the tablets. The study found objective response rate was 34%. In addition, 23% of patients were in stable disease for at least 16 weeks after initiation of single olaparib treatment. Olaparib was metabolized by cytochrome P450 enzyme (CYP450). Therefore, olaparib should be avoided in patients receiving inhibitors or inducers of CYP3A4/ 5 such as itraconazole and rifampicin. Previous studies reported low to moderate levels of transient and reversible adverse drug reactions in patients with olaparib including nausea (71%), fatigue (52%), vomiting (34%), diarrhea (27%), abdominal pain (25%), and anemia (21%). These reactions are usually found during the first month after starting olaparib. Severe adverse reactions were myelodysplastic syndrome and acute myeloid leukemia.
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ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
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