Sharing real-world experiences to optimize the management of olaparib toxicities: a practical guidance from an Italian expert panel

D. Lorusso, A. Bologna, S.C. Cecere, E. De Matteis, G. Scandurra, C. Zamagni, V. Arcangeli, F. Artioli, M. Bella, G. Blanco, C. Cardalesi, C. Casartelli, R. De Vivo, M. Di Napoli, E.B. Gisone, R. Lauria, A.A. Lissoni, V. Loizzi, E. Maccaroni, G. MangiliC. Marchetti, F. Martella, E. Naglieri, V. Parolin, G. Ricciardi, G. Ronzino, V. Salutari, G. Scarfone, S. Secondino, I. Spagnoletti, G. Tasca, G. Tognon, V. Guarneri

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Pages (from-to)2435-2442
Number of pages8
JournalSupportive Care in Cancer
Issue number5
Publication statusPublished - 2020


  • Adherence
  • Clinical practice
  • Olaparib
  • Recurrent ovarian cancer
  • Toxicities
  • Transition
  • cytochrome P450 3A inhibitor
  • olaparib
  • antineoplastic agent
  • BRCA1 protein
  • BRCA1 protein, human
  • BRCA2 protein
  • BRCA2 protein, human
  • nicotinamide adenine dinucleotide adenosine diphosphate ribosyltransferase inhibitor
  • phthalazine derivative
  • piperazine derivative
  • algorithm
  • anemia
  • Article
  • clinical practice
  • fatigue
  • general condition deterioration
  • human
  • Italy
  • job experience
  • lifestyle modification
  • microcapsule
  • nausea and vomiting
  • nutritional health
  • patient care
  • priority journal
  • psycho-oncology
  • tablet
  • toxicity
  • female
  • genetics
  • mutation
  • nausea
  • ovary tumor
  • tumor recurrence
  • vomiting
  • Anemia
  • Antineoplastic Agents
  • BRCA1 Protein
  • BRCA2 Protein
  • Fatigue
  • Female
  • Humans
  • Mutation
  • Nausea
  • Neoplasm Recurrence, Local
  • Ovarian Neoplasms
  • Phthalazines
  • Piperazines
  • Poly(ADP-ribose) Polymerase Inhibitors
  • Vomiting


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