臨床婦人科産科74巻3号

2020年04月発行

今月の臨床 徹底解説！ 卵巣がんの最新治療―複雑化する治療を整理する

新規治療薬の作用機序と使いどころ《分子標的薬・免疫チェックポイント阻害薬》

PARP阻害薬の作用機序と使いどころ

著者： 渡邉絵里¹ 梶山広明¹

所属機関： ¹名古屋大学大学院医学系研究科産婦人科学講座

ページ範囲：P.334 - P.343

文献概要

●PARP阻害薬は，DNA修復機構において一本鎖切断修復を妨げるため，二本鎖切断修復機構に異常をきたした細胞に投与することで，細胞死を導く（合成致死）．

●再発卵巣がん治療 : オラパリブ，ニラパリブ，ルカパリブの3剤いずれも，BRCA遺伝子変異陽性もしくは腫瘍が相同組換修復異常を有する症例で，プラセボ群に比較し，大幅なprogression-free survival（PFS）の延長を認めた．

●新規に診断された進行卵巣がんの一次維持療法 : オラパリブはBRCA遺伝子変異を有しプラチナ製剤感受性の症例，ニラパリブはBRCAの有無にかかわらず，相同組換修復異常を認める症例で，progression-free survivalを改善した．

●有害事象 : オラパリブでは貧血，ニラパリブでは血小板減少が多く報告されるなど，各薬剤により有害事象が異なるため，投与に際し注意が必要である．

参考文献

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錠（オラパリブ錠）医薬品インタビューフォーム．http://www.pmda.go.jp/safety/info-services/drugs/0001.html

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