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Sharing real-world experiences to optimize the management of olaparib toxicities: a practical guidance from an Italian expert panel.
Supportive Care in Cancer ( IF 3.1 ) Pub Date : 2020-02-11 , DOI: 10.1007/s00520-020-05320-4
Domenica Lorusso 1 , Alessandra Bologna 2 , Sabrina Chiara Cecere 3 , Elisabetta De Matteis 4 , Giusy Scandurra 5 , Claudio Zamagni 6 , Valentina Arcangeli 7 , Fabrizio Artioli 8 , Mariangela Bella 9 , Giusi Blanco 10 , Cinzia Cardalesi 11 , Clelia Casartelli 12 , Rocco De Vivo 13 , Marilena Di Napoli 3 , Emanuele Baldo Gisone 14 , Rossella Lauria 11 , Alberto Andrea Lissoni 15, 16 , Vera Loizzi 17 , Elena Maccaroni 18 , Giorgia Mangili 19 , Claudia Marchetti 1 , Francesca Martella 20 , Emanuele Naglieri 21 , Veronica Parolin 22 , Giusy Ricciardi 23 , Graziana Ronzino 4 , Vanda Salutari 1 , Giovanna Scarfone 24 , Simona Secondino 25 , Ilaria Spagnoletti 26 , Giulia Tasca 27 , Germana Tognon 28 , Valentina Guarneri 27
Affiliation  

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.

中文翻译:

分享现实生活中的经验,以优化奥拉帕尼的毒性管理:意大利专家小组的实用指南。

Olaparib是第一种被批准用于BRCA突变复发性卵巢癌(OC)患者的维持治疗的聚(ADP-核糖)聚合酶抑制剂。为了获得最大的临床收益,必须坚持奥拉帕尼治疗。然而,在临床实践中,这经常受到毒性的次优处理的挑战。考虑到奥拉帕尼也在意大利的广泛使用,医生必须学习如何充分和迅速地管理药物毒性,以免不必要地中断或减少剂量。专家一致认为,恶心,呕吐,贫血和疲劳是olaparib OC患者最常发生的事件,这些毒性通常在治疗过程中早期产生,主要为1-2级且短暂,可以通过简单的非口服药物来控制-药物干预。通过分享他们的真实经验,专家组针对每种毒性,按照等级和当地标签指示的程序,准备了一种算法,包括基于营养和生活方式改变以及心理肿瘤学咨询的支持性护理干预措施。此外,鉴于片剂进入意大利市场,比较了胶囊和片剂的完整剂量和减少剂量。该实用指南旨在成为支持特别是经验不足的医师处理这些复杂患者的工具,以帮助防止患者病情恶化和不必要的奥拉帕尼剂量中断/减少,这可能会危及治疗功效。除本地标签中指示的程序外,按等级组织的算法,还包括基于营养和生活方式改变以及心理肿瘤学咨询的支持性护理干预措施。此外,鉴于片剂进入意大利市场,比较了胶囊和片剂的完整剂量和减少剂量。该实用指南旨在成为支持特别是经验不足的医师处理这些复杂患者的工具,以帮助防止患者病情恶化和不必要的奥拉帕尼剂量中断/减少,这可能会危及治疗功效。除本地标签中指示的程序外,按等级组织的算法,还包括基于营养和生活方式改变以及心理肿瘤学咨询的支持性护理干预措施。此外,鉴于片剂进入意大利市场,比较了胶囊和片剂的完整剂量和减少剂量。该实用指南旨在成为支持特别是经验不足的医师处理这些复杂患者的工具,以帮助防止患者病情恶化和不必要的奥拉帕尼剂量中断/减少,这可能会危及治疗功效。鉴于片剂进入意大利市场,比较了胶囊和片剂的完整剂量和减少剂量。该实用指南旨在成为支持特别是经验不足的医师处理这些复杂患者的工具,以帮助防止患者病情恶化和不必要的奥拉帕尼剂量中断/减少,这可能会危及治疗功效。鉴于片剂进入意大利市场,比较了胶囊和片剂的完整剂量和减少剂量。该实用指南旨在成为支持特别是经验不足的医师处理这些复杂患者的工具,以帮助防止患者病情恶化和不必要的奥拉帕尼剂量中断/减少,这可能会危及治疗功效。
更新日期:2020-04-22
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