What Is Rucaparib?
Rucaparib is an oral drug used as chemotherapy for ovarian cancer. Rucaparib is a PARP1 (Poly (ADP-ribose) polymerase (PARP), PARP2, and PARP3 inhibitor used as a chemotherapy for BRCA (breast cancer gene)-mutated ovarian cancer. PARP1, PARP2, and PARP3 repair damaged DNA in cancer cells. PARP enzymes are unable to repair DNA (deoxyribonucleic acid) in the absence of a functional BRCA1 gene. Therefore, PARP inhibitors work as anti-neoplastic agents.
Recently, three PARP inhibitors have been approved, namely: Olaparib, Rucaparib, and Niraparib. PARP inhibitors are suggested in HR Heart rate-deficient tumors. Rucaparib is used as maintenance therapy after chemotherapy for patients with recurrent ovarian cancer.
Is Rucaparib Approved by the FDA?
Yes, Rucaparib was approved by the FDA (Food and Drug Administration) on April 6, 2018.
What Are the Causes of Ovarian Cancer?
The majority of cancers do not result from a single factor. It results from:
-
The complex interaction between genetic factors and exposure to environmental carcinogens (a substance that promotes cancer formation). Genetic and environmental factors play an important role in causing ovarian cancer.
-
Ovarian cancer is caused by a mutation of the BRCA1 or BRCA2 gene. BRCA1 or BRCA2 are genes located in the long arm of chromosome 17. These genes are referred to as caretaker genes as they repair the deoxyribonucleic acid (DNA).
-
Older age, family history, and ovarian stimulation all increase the risk of ovarian cancer.
On the other hand, suppressed ovulation, pregnancy, prolonged breastfeeding, and contraceptive pills have all been shown to reduce the risk of ovarian cancer.
What Are the Symptoms of Ovarian Cancer?
The patient is asymptomatic in the early stages of ovarian cancer, and symptoms appear in the advanced stages of ovarian cancer.
The following are the symptoms of ovarian cancer:
-
Vague abdominal discomfort.
-
Abdominal swelling.
-
Vaginal discomfort.
-
Fatigue.
-
Low back pain.
-
Altered bowel habits (such as constipation).
-
Weight loss.
How Is Ovarian Cancer Diagnosed?
The patient history, physical examination, and imaging techniques diagnose women with ovarian cancer.
The patient with ovarian cancer can be diagnosed in the following ways:
-
Patient History - The patient’s full history provides information on family history and habits, such as smoking or occupational exposure to infection.
-
Physical Examination - The palpation of viscera can be done on a physical examination. The abdominal mass swelling is palpable as an omental cake.
-
Blood Test - The serum level of tumor marker CA-125 (Cancer antigen 125) is measured with the help of a blood test.
-
Ultrasound - Ultrasound can be performed to define the extent and location of the tumor.
-
Computed Tomography (CT Scan) - This imaging technique produces high-resolution images of organs. It helps to define the course, location, staging, and extent of tumors.
How Is Ovarian Cancer Treated?
The early stage of ovarian cancer is usually treated with surgery followed by chemotherapy. Surgery aims at removing the tumor, and depending on the stage, it might involve the removal of one or both ovaries, fallopian tubes, the uterus, and nearby tissues to ensure that all the visible cancer is removed.
This surgical approach, called debulking or cytoreductive surgery, considerably improves outcomes by reducing the tumor burden.
Following surgery, chemotherapy with carboplatin and paclitaxel is the treatment of choice and is standardly used as adjuvant therapy. Chemotherapy can also be given prior to surgery in advanced diseases as neoadjuvant chemotherapy to reduce the size of the tumor and make surgical intervention more effective.
Treatment may include platinum-based drugs - such as carboplatin or cisplatin combination with taxane drugs, such as paclitaxel, and sometimes other agents like topotecan or liposomal doxorubicin as a combination therapy to attack residual cancer cells.
Sometimes, based on tumor biologic behavior and individualized patient factors, other options, including targeted therapies or hormone therapies, are recommended. Participation in clinical trials and newer approaches, including intraperitoneal chemotherapy, is also considered in comprehensive care.
What Is the Role of Rucaparib in Ovarian Cancer?
According to studies, all women who respond to platinum therapy and receive Rucaparib live approximately one year without disease progression. The role of Rucaparib in patients with HRD tumors has shown up to a 1.5-year progression-free survival rate. The accepted dose of Rucaparib is 600 mg orally twice daily.
The common side effects of Rucaparib are as follows
-
Vomiting.
-
Fatigue.
-
Anemia.
-
Altered bowel habits such as constipation.
Therefore, Rucaparib is effective with fewer side effects.
Conclusion
Rucaparib is a new therapeutic option used as maintenance therapy in ovarian cancer with few side effects. Rucaparib has been proven effective by clinical trials to be used as treatment therapy and maintenance therapy in recurrent ovarian cancer cases. The future trials of Rucaparib may show a positive result to be used as the first line of treatment in BRCA1 or BRCA2 mutated ovarian cancer. Researchers have expanded the use of Rucaparib with immunotherapies (combination therapy) for HRD (homologous recombination deficiency) tumors. Rucaparib prolonged lifespan in women with ovarian cancer without disease progression. If you are taking this medicine, or if you have questions about it, you can always ask a cancer specialist. They are there to help and explain everything to you.
Key Takeaways
-
Rucaparib is a medicine used to treat cancer. It helps people with ovarian cancer and some other cancers.
-
It also works for some cancers that have a BRCA change, like certain ovarian and prostate cancers.
-
It works by blocking PARP, which helps fix DNA. When PARP is blocked, cancer cells cannot fix themselves, so they break and die.
-
This medicine is usually taken by mouth. It is used for maintenance therapy to keep the cancer under control, often for about two years.
