Episode 367: Pharmacology 101: PARP Inhibitors

“We know that in cells that are proliferating very quickly, including cancer cells, single-strand DNA breaks are very common. When that happens, these breaks are often repaired by the PARP enzyme, and the cells can continue their replication process. If we block PARP, that repair cannot happen. So in blocking that, these single-strand breaks then lead to double-strand breaks, which ultimately is leading to cell apoptosis,” Danielle Roman, PharmD, BCOP, manager of clinical pharmacy services at the Allegheny Health Network Cancer Institute in Pittsburgh, PA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the PARP inhibitor drug class.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0 

Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by June 13, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to the use of PARP inhibitors in cancer care.

Episode Notes 

• Complete this evaluation for free NCPD. 
• ONS Podcast™ episodes:
• Pharmacology 101 series
• Episode 330: Stay Up to Date on Safe Handling of Hazardous Drugs
• Episode 232: Managing Fatigue During PARP Inhibitor Maintenance Therapy
• Episode 227: Biomarker Testing, PARP Inhibitors, and Oral Adherence During Ovarian Cancer Maintenance Therapy
• ONS Voice articles:
• PARP Inhibitors and Ovarian Cancer
• Genomics May Trick PARP Inhibitors to Treat More Cancers
• Oncology Drug Reference Sheet: Niraparib
• ONS books:
• Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)
• Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition)
• Safe Handling of Hazardous Drugs (fourth edition)
• ONS courses: Safe Handling Basics
• Clinical Journal of Oncology Nursing articles:
• PARP Inhibition: Genomics-Informed Care for Patients With Malignancies Driven by BRCA1/BRCA2 Pathogenic Variants
• Talazoparib Plus Enzalutamide in Patients With HRR-Deficient mCRPC: Practical Implementation Steps for Oncology Nurses and Advanced Practice Providers
• Oncology Nursing Forum article: Familiarity and Perceptions of Ovarian Cancer Biomarker Testing and Targeted Therapy: A Survey of Oncology Nurses in the United States
• Oral Anticancer Medication Care Compass: Resources for Interprofessional Navigation
• ONS Biomarker Database
• ONS Oral Anticancer Medication Learning Library
• ONS Oral Anticancer Medication Toolkit
• Oral Chemotherapy Education Sheets

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.

To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.

To provide feedback or otherwise reach ONS about the podcast, email [email protected].

Highlights From This Episode

“The big toxicities here to watch for are primarily hematologic toxicities. It is one of those targeted therapies that does affect blood cell counts. So I’d say the blood cell count that is most commonly affected here is the hemoglobin. So, anemia very frequent complication that we see, probably a little bit more with olaparib compared with other drugs, but we see it as a class side effect. And we can also see neutropenia and thrombocytopenia with these agents, probably a little bit more with niraparib versus the others, but again, you can see it across all of these drugs.” TS 8:16

“We mentioned that rare risk of MDS and AML. This isn’t a particularly scary thing if you talk to patients about it. Because of the rarity that we see this, it isn’t something that we need to overemphasize, but I think careful monitoring of blood counts in is stressing the importance of that and early intervention here is very important.” TS 16:55

“This is a collaborative effort. And because of the home administration here, these patients do need to be followed very closely. So we are not laying eyes on them usually with the frequency that we do when we have patients actually coming into our infusion centers for treatments—so making sure that there is a plan for regular follow-up with these patients to ensure that they’re getting that lab work done, that that’s being looked at closely, that we’re adjusting the dose if we need to based on that lab work, that we are managing the patient’s fatigue. Again, that potentially dose reductions may be needed if patients are having that extreme fatigue.” TS 19:34

“I think one of those [misconceptions] could be that they’re only effective in patients that have that BRCA1/2 mutation. And again, remember here that there is some data in particular disease states that we can use them and that they work in the absence of those mutations.” TS 25:12