From the Research
Olaparib should not be held during intercurrent infections, as recent evidence suggests it may have beneficial effects on infection outcomes, particularly in the context of influenza-virus-induced pneumonia, as shown in a 2021 study 1. However, the decision to continue or discontinue olaparib during an intercurrent infection should be made on a case-by-case basis, considering the severity of the infection, the patient's overall condition, and their ability to tolerate the medication. Some key points to consider include:
- Olaparib can cause bone marrow suppression, which may worsen infection outcomes, but it may also have anti-inflammatory effects that could be beneficial in certain contexts, such as influenza-virus-induced pneumonia 1.
- Infections may alter drug metabolism and increase toxicity risk, but the impact of this on olaparib is not well understood.
- The added physiological stress of fighting an infection while managing potential drug side effects can be challenging for patients.
- For mild infections without systemic symptoms, it may be reasonable to continue olaparib with close monitoring, but for moderate to severe infections requiring antibiotics or hospitalization, temporarily suspending olaparib may be advisable.
- Once the infection resolves, olaparib can typically be resumed at the previous dose, though in some cases a dose reduction might be necessary if the patient experienced significant toxicity or prolonged interruption. It's essential to consult with the prescribing oncologist before making any changes to olaparib dosing, as they can provide personalized guidance based on the patient's specific situation and medical history. Additionally, recent studies have shown that olaparib can be safely administered to women with germline BRCA1/2-mutant high-grade serous ovarian cancer, even as a second course of treatment, with modest efficacy and manageable toxicity 2. However, the primary consideration should always be the patient's overall health and well-being, and decisions regarding olaparib dosing should be made with the goal of minimizing morbidity, mortality, and improving quality of life.