NCCN Guidelines for Patients
Ovarian Cancer, Version 1.2017
genes also help repair
DNA damage in cells. But, mutations in these genes
prevent them from making needed repairs. When
cancer cells have mutations in the
they now must rely on PARP to repair DNA. These
drugs block the action of PARP so that the PARP
can no longer repair DNA damage in any cells. This
now makes it very hard for cancer cells with
mutations to repair damaged DNA. If a cell is not
able to repair damaged DNA, it will die.
While all three drugs work the same, each of
these agents have been approved for certain use
to treat ovarian cancer. Typically patients need to
germline mutation. For
example, olaparib is used in patients with
mutations who have progressed after three lines
of prior chemotherapy treatment. Rucaparib is
given to those who have recurrent disease that
is platinum sensitive. Platinum sensitive means
the cancer initially responded to a platinum-based
chemotherapy but the cancer came back (recurred)
more than 6 months after treatment. Niraparib is
used in the recurrent setting but as maintenance
therapy (to help maintain a good response) after a
Some common side effects of olaparib, rucaparib,
and niraparib are nausea, vomiting, diarrhea,
stomach pain, muscle or joint pain, feeling tired or
weak, not feeling hungry, and low blood cell counts.
Pazopanib is a type of targeted therapy called a
nhibitor). Tyrosine kinases
are proteins in cells that are important for many cell
functions. This includes sending signals in cells for
cell growth, survival, and death.
Some tyrosine kinases send signals that tell cancer
cells to grow and divide to make new cells.
Some send signals for new blood vessels to grow
into the tumor so it can survive. Pazopanib targets
several tyrosine kinases and blocks the signals that
help cancer grow and spread. Blocking these signals
may slow cancer growth.
Common side effects of pazopanib include diarrhea,
high blood pressure, and change in hair color,
nausea, vomiting, fatigue, and not feeling hungry.
Hormone therapy is treatment that stops the body
from making certain hormones or stops the action of
the hormones. Hormone therapy is not used as initial
treatment for ovarian cancer. But, it may be used
for ovarian cancer that has come back after other
Estrogen and progesterone are hormones that help
some ovarian cancers grow. Estrogen is mostly made
by the ovaries and is made in small amounts by the
adrenal glands, liver, and body fat. Progesterone
is also mostly made by the ovaries. Blocking these
hormones from working or lowering hormone levels
may help slow ovarian cancer growth.
Different types of hormone therapy drugs work in
different ways. The hormone therapy drugs that may
be used for ovarian cancer include:
Tamoxifen – This drug stops the effect of
estrogen on cancer cell growth. It is in a class
of drugs called antiestrogens.
Anastrozole, exemestane, and letrozole –
These drugs lower estrogen levels in the body.
They are in a class of drugs called aromatase