Rechallenging with Parp Inhibitors

[Divine21]

Hi

This is the first time I've posted on here. I'd just like to know if anyone has been prescribed a parp inhibitor for a second time. I was put on Niraparib after 2nd line chemo but had to stop after 5 months because of serious side effects. It was working but when they reduced the dose to 100mg a day my cancer returned. I'm now on 3rd line chemo and would really like to try olaparib ( I'm BRCA 2 positive). I've heard that the side effects are less severe. I'm even willing to self fund it although it's horrendously expensive. If someone has tried a second parp inhibitor I might be able to persuade my oncologist that it could be an option. Any advice would be greatly appreciated. Thanks.

[SUE7777]

I'm not an expert but I've heard if one isn't working then probably none will work but definitely run it by your onc.. You don't want to waste money on something that doesn't work when there could be something out there that does. Also ask why you were not given Olaparib, there might be a reason. Take care and all the best, hope it helps. Sue xx

[Divine21 in reply to SUE7777]

Thanks for your reply. I'm afraid olaparib was only available after 3rd line chemo at that time. It's all changed since then. There seems to be so many rules and regulations. It's a minefield trying to get the information. It's a shame I had to stop Niraparib because it gave me a year's remission. Anyway I'm hoping to get a second opinion. You never know. There might be some wonder drug out there! X

[SUE7777 in reply to Divine21]

I'm sure there is but also ask for the olaparib and see what they say as well as getting a 2nd opinion. Cover all options. Good luck and take care. Sue xx

[delia2]

Hi. Self funding would be prohibitive but Astra Zeneca funds people in the US who can’t get insurance. Since Niraparib did work for you and you’re BRCA positive I would think you’d have a good chance of Olaparib working. I know there are trials combining Olaparib with other meds but they cause more side effects.

[mupash in reply to delia2]

HI DELIA,

JUST WANTED TO CLARIFY... ASTRA ZENECA DOESN'T FUND THOSE WITHOUT INSURANCE. IT DOES PROVIDE THE DRUG IF YOUR INCOME IS LESS THAN $62,000. A YEAR. I DID NOT QUALIFY BUT HAVE INSURANCE WHICH LEAVES ME WITH A LITTLE OVER 2,100. IN JANUARY AND FEBRUARY AND IT GOES DOWN TO ABOUT 700. A MONTH AFTER THAT. I HOPE SHE CAN GET IT AND IT HELPS.

LEE

[WoodyB]

First of all, you're right that olaparib is horrendously expensive.

Without the complication of your 5 months on niraparib, your BRCA2 status would entitle you to start NHS funded olaparib within 8 weeks of finishing 3rd line chemo (provided you have responded).

As you responded clinically to niraparib it would seem reasonable for you to be allowed to try olaparib, but this might require a special submission from your oncologist. Anecdotally olaparib seems to be better tolerated than niraparib, so this should be a relevant factor in the submission.

I recommend talking about this now with your oncologist, whilst you are still having chemo, as it might take some time to get a decision and you need to start olaparib within 8 weeks of finishing chemo.

If your oncologist won't play ball, try a 2nd opinion.

In due course please report back to the forum, as I'm sure other ladies will find this useful.

Good luck, Woody x

[Divine21]

Thanks. I've asked for a second opinion from someone at the Royal Marsden. I'll let you know what the outcome is.

[WoodyB in reply to Divine21]

Just wondered if you were able to get olaparib and, if so, how are you doing? x

[Ruebacelle]

In the usa they have approved combinations of parps plus avastin or 2 parps. Especially for brca positive...so its worth pursuing your 2nd parp option