Targeted cancer drugs for ovarian cancer
Targeted cancer drugs change the way that cells work and help the body control the growth of cancer. Olaparib and bevacizumab are 2 types of targeted drugs for advanced ovarian cancer.
What are targeted cancer drugs?
Targeted cancer drugs act on processes in cells or change the way that cells signal to each other. They can stimulate the body to attack or control the growth of cancer cells.
They can help some women with advanced ovarian cancer that has come back after previous treatment.
Although these treatments can’t cure the cancer, they may help to control it for a while. And help some people to live longer.
When you might have targeted drug treatments
You might have a type of targeted cancer drug as a treatment for advanced ovarian cancer.
Whether you have targeted therapy depends on:
- the type of cancer you have
- how far the cancer has grown (the stage)
- other treatments you've already had
- whether your cancer has changes (mutations) in a gene called BRCA
Types of targeted cancer drugs
Olaparib (Lynparza)
Olaparib is a type of targeted cancer drug called a PARP inhibitor. PARP is short for Poly (ADP-ribose) polymerase. It is a protein that helps damaged cells to repair themselves. Olaparib stops PARP working.
This type of drug is called a cancer growth blocker.
Bevacizumab (Avastin)
Bevacizumab targets a cancer cell protein called vascular endothelial growth factor (VEGF). This protein helps cancers to grow blood vessels, so they can get food and oxygen from the blood. All cancers need a blood supply to be able to survive and grow.
Bevacizumab blocks this protein and stops the cancer from growing blood vessels. This is so it is starved and can't grow.
Treatments that interfere with the development of a blood supply are called anti angiogenesis treatments.
Other drugs
Niraparib (Zejula) and rucaparib (Rubraca) are types of PARP inhibitors. Doctors sometimes use them to treat ovarian cancer that has come back (relapsed).
Researchers are looking at some other targeted cancer drugs such as cediranib, in trials for ovarian cancer.
Are these drugs available in the UK?
New cancer drugs are licensed for use in a particular way. For example, a drug might have a license to treat a particular stage or type of ovarian cancer.
Once a drug has a license, several independent organisations approve the new cancer drugs before doctors can prescribe them on the NHS.
In England the National Institute for Health and Care Excellence (NICE) decides which drugs and treatments are available on the NHS.
In Wales, the All Wales Medicines Strategy Group (AWMSG) advises NHS Wales. They generally follow NICE decisions but can also issue their own guidance,
The Scottish Medicines Consortium (SMC) advises NHS Scotland. Its decisions are separate from decisions made by NICE.
The Department of Health advises about health and social care in Northern Ireland. They usually follow NICE decisions.
Olaparib is a drug that treats high grade ovarian cancer that has spread. This includes people with high grade fallopian tube cancer and peritoneal cancer.
It's used to treat people who have responded well to a type of chemotherapy called platinum chemotherapy. Doctors call this platinum sensitive.
It is for women who have a change in a gene called BRCA.
NICE and SMC have approved olaparib. its now available in the UK in one of the following situations.
- your cancer has come back (relapsed), you've had platinum chemotherapy and you’ve previously responded well to this chemotherapy
- you are newly diagnosed and your cancer has responded well to platinum chemotherapy
Clinical trials
It might be possible to join a clinical trial looking at olaparib.
Niraparib has a drug license as a maintenance treatment for high grade ovarian cancer that has come back (relapsed) after responding well to platinum chemotherapy. Doctors call this platinum sensitive cancer. Carboplatin is a type of platinum chemotherapy.
Maintenance treatment aims to stop cancer from coming back or growing for as long as possible.
England, Wales and Northern Ireland
NICE has recommended that niraparib is available through the cancer drugs fund in England. It's also available in Northern Ireland, and in Wales under the new treatment fund.
It's for women with high grade ovarian cancer that has come back, and responded well to platinum chemotherapy. You might have it if you:
- have changes (mutations) in the BRCA gene and have had 2 courses of platinum chemotherapy
- don't have changes in the BRCA gene and have had 2 or more courses of platinum chemotherapy
Scotland
In Scotland, the SMC has approved niraparib for use on NHS Scotland. You might have it for high grade ovarian cancer that has come back after responding well to platinum chemotherapy and if you:
- don't have changes in the BRCA gene
Avastin has a drug license for advanced ovarian cancer. You have it in combination with chemotherapy.
England, Wales and Northern Ireland
Avastin has not been approved by NICE. It's available on the NHS in England through the cancer drugs fund as a first treatment for some women with advanced ovarian cancer, combined with chemotherapy. It's also available in Wales through the One Wales Interim Commissioning process. It isn't available in Northern Ireland.
Scotland
In Scotland, the SMC has approved Avastin in specific situations. It's available on NHS Scotland in combination with paclitaxel, if:
- your cancer has not responded to carboplatin chemotherapy
- you haven't had more than 2 courses of chemotherapy
- you haven't previously had Avastin or a similar type of drug
It is also available as a first treatment combined with carboplatin and paclitaxel, for women with stage 4 ovarian cancer
Clinical trials
It might be possible to join a clinical trial looking at avastin.
Rucaparib has a drug license as a maintenance treatment for high grade ovarian cancer that has come back (relapsed) after responding well to platinum chemotherapy. Doctors call this platinum sensitive cancer. Carboplatin is a type of platinum chemotherapy.
Maintenance treatment aims to stop cancer from coming back or growing for as long as possible.
England, Wales and Northern Ireland
NICE has recommended that rucaparib is available through the cancer drugs fund in England. Medicines on the Cancer Drugs Fund in England are also usually made available to patients in Wales and Northern Ireland.
It's for women with high grade ovarian cancer that has come back and responded well to platinum chemotherapy. It's available both for women who have changes (mutations) in the BRCA gene, and for those who don't have BRCA gene changes.
You might have it if you have had 2 or more courses of platinum chemotherapy.
Scotland
In Scotland, rucaparib is not available at the moment.
Olaparib with bevacizumab is available as ongoing treatment for:
high grade 
epithelial ovarian cancer- fallopian tube cancer
- primary peritoneal cancer
You may have it if your cancer:
- has completely or partially responded after
first-line platinum -based chemotherapy with bevacizumab - is
advanced (FIGO stages 3 and 4)
Your cancer also needs to be homologous recombination deficiency (HRD) positive. This means it has one or both of the following:
- a
BRCA1 or BRCA2 gene change (mutation ) - an increased tendency for gene changes (genomic instability)
General side effects
Side effects depend on the type of drug you are having, some of the common side effects include:
- tiredness (fatigue)
- loss of appetite
- a sore mouth
- low levels of blood cells
- feeling sick
Having targeted cancer drugs
You have your treatment as tablets or capsules, or through a tube into your bloodstream. This depends on the type of drug you have.
Tablets or capsules
You should take the right dose, not more or less.
Talk to your healthcare team before you stop taking a cancer drug, or if you have missed a dose.
Into the bloodstream
You have this treatment through a drip into your arm. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.
You may need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.
