Assessing Dosing for Rucaparib When Treating Patients With Ovarian Cancer

Pharmacy Times interviewed Thomasina Morris, RPh, MHA, BCOP, pharmacist at Moffitt Cancer Center, on how rucaparib is used to treat patients with ovarian cancer.

Thomasina Morris: So, with rucaparib, we find that there is actually a starting dose of 600 milligrams PO bid, then you can go through at least 3 dose reductions--500 milligrams PO bid, down to another dose reduction of 400 milligrams PO bid, down to the final dose reduction of 300 milligrams PO bid.

Now, most patients, depending on whether they're going in for a second line or recurrence, will determine where they will start. So, some patients will be coming off chemotherapy, and they may or may not want to initiate another medication right away. They might have had a lot of complications, or they might have had a lot of fatigue or tiredness or just side effects from the chemotherapy that might make them want to reconsider.

But those that do, then we look at how they tolerated their previous treatment. Because they've had at least 2 lines of chemotherapy, we know that what's happening to them with that chemotherapy might mimic a little bit of what will happen with them on rucaparib.

So, we keep that in mind and look historically at how these patients were treated, and that's a big plus for a pharmacist to work with a provider to know, historically, how these patients tolerated their treatment from the beginning to when they finished. This gives the provider an idea: Should I start at the higher dose of 600, or maybe start at 500? Should I be looking at their kidneys? Should I be looking at their bone marrow suppression? Things like that will come into play.

So that's how a lot of the conversations go when you're looking at assessing patients starting on rucaparib.