Formulary

8.6.4 Poly (ADP-ribose) polymerase inhibitors

First Line
Second Line
Specialist
Hospital Only
Niraparib
  • Capsules 100mg

Notes

  1. NICE TA673: Niraparib (Zejula) is recommended for use within the Cancer Drugs Fund as an option for maintenance treatment for advanced (FIGO stages 3 and 4) high-grade epithelial ovarian, fallopian tube or primary peritoneal cancer after response to first-line platinum-based chemotherapy in adults, only if the conditions in the managed access agreement are followed (February 2021).
  2. NICE TA784: Niraparib (Zejula) is recommended as an option for treating relapsed, platinum-sensitive high-grade serous epithelial ovarian, fallopian tube or primary peritoneal cancer that has responded to the most recent course of platinum-based chemotherapy in adults (April 2022). It is recommended only if:
    1. they have a BRCA mutation and have had 2 courses of platinum-based chemotherapy, or
    2. they do not have a BRCA mutation and have had 2 or more courses of platinum-based chemotherapy, and
    3. the company provides it according to the commercial arrangement.
  3. MHRA Drug Safety Update (October 2020): Niraparib (Zejula): reports of severe hypertension and posterior reversible encephalopathy syndrome (PRES), particularly in early treatment.
Olaparib
  • Tablets 100mg, 150mg

Notes

  1. NICE TA908: Olaparib (Lynparza) is recommended as an option for the maintenance treatment of relapsed, platinum-sensitive, high-grade epithelial ovarian, fallopian tube, or primary peritoneal cancer in adults whose cancer has responded to platinum-based chemotherapy (July 2023), only if:
    1. they have a BRCA1 or BRCA2 mutation
    2. they have had 2 or more courses of platinum-based chemotherapy
    3. the company provides it according to the commercial arrangement.
  2. NICE TA886: Olaparib (​Lynparza​) (alone or with endocrine therapy) ​is recommended​, within its marketing authorisation, as an option for the adjuvant treatment of HER2-negative high-risk early breast cancer that has been treated with neoadjuvant or adjuvant chemotherapy in adults with germline BRCA1 or 2 mutations, only if the company provides it according to the commercial arrangement (May 2023).
  3. NICE TA887: Olaparib (Lynparza) is recommended, within its marketing authorisation, as an option for treating hormone-relapsed metastatic prostate cancer with BRCA1 or BRCA2 mutations that has progressed after a newer hormonal treatment (such as abiraterone or enzalutamide) in adults, only if the company provides it according to the commercial arrangement (October 2022).
  4. NICE TA946: Olaparib (Lynparza) with bevacizumab (Avastin) is recommended, within its marketing authorisation, for maintenance treatment of high-grade epithelial ovarian, fallopian tube or primary peritoneal cancer in adults (January 2024) whose cancer:
    1. has completely or partially responded after first-line platinum-based chemotherapy with bevacizumab,
    2. is advanced (International Federation of Gynaecology and Obstetrics [FIGO] stages 3 and 4) and
    3. is homologous recombination deficiency (HRD) positive (defined as having either a BRCA1 or BRCA2 mutation, or genomic instability).
  5. NICE TA951: Olaparib (Lynparza) with abiraterone and prednisone or prednisolone is recommended, within its marketing authorisation, as an option for untreated hormone-relapsed metastatic prostate cancer in adults who cannot have or do not want chemotherapy, only if the company provides it according to the commercial arrangements (February 2024).
  6. NICE TA962: Olaparib (Lynparza) is recommended, within its marketing authorisation, as an option for maintenance treatment of BRCA mutation-positive, advanced (FIGO stages 3 and 4), high-grade epithelial ovarian, fallopian tube or primary peritoneal cancer that has responded to first-line platinum-based chemotherapy in adults, only if the company provides it according to the commercial arrangement (March 2024).
Rucaparib
  • Tablets 200mg, 250mg, 300mg

Notes

  1. NICE TA1007: Rucaparib (Rubraca) is recommended, within its marketing authorisation, as an option for the maintenance treatment of relapsed platinum-sensitive high-grade epithelial, ovarian, fallopian tube or primary peritoneal cancer that has completely or partially responded to platinum-based chemotherapy in adults, only if the company provides it according to the commercial arrangement (September 2024).
Talazoparib
  • Capsules 0.25mg, 1mg

Notes

  1. NICE TA952: Talazoparib (Talzenna) is recommended, within its marketing authorisation, for treating HER2-negative, locally advanced or metastatic breast cancer with germline BRCA1 or BRCA2 mutations in adults who have had (February 2024):
    1. an anthracycline or a taxane, or both, unless these treatments are not suitable, and
    2. endocrine therapy if they have hormone receptor (HR)-positive breast cancer, unless this is not suitable, and
    3. the company provides it according to the commercial arrangement.