METHODS: Following the Delphi method, statements to optimize PARP inhibitor management were drafted by a multidisciplinary Steering Committee made up of 17 experts. These statements were submitted to the independent and anonymous vote of clinicians involved in treating patients on PARP inhibitors.
RESULTS: This article presents 52 statements on the following topics: initiation and treatment; management of adverse events (hematological effects, gastrointestinal effects, renal effects, pulmonary effects, cutaneous effects, hypertension, insomnia, fatigue, dizziness); special populations and situations; communication with the patient; adherence. Forty-nine statements obtained voter consensus after 3 voting rounds. A hematologist and a nephrologist supplemented this task by drafting an expert opinion on the risk of occurrence of secondary leukemia and nephrological toxicity.
CONCLUSIONS: This paper is the first Delphi consensus on the practical management of PARP inhibitors. The pragmatic recommendations resulting from this paper should make it possible to manage the side effects of PARP inhibitors better and thus prevent early treatment discontinuation and improve patient adherence by preserving quality of life.
方法:遵循Delphi方法,由17名专家组成的多学科指导委员会起草了优化PARP抑制剂管理的声明.这些陈述提交给参与PARP抑制剂治疗患者的临床医生的独立和匿名投票。
结果:本文提供了有关以下主题的52项陈述:开始和治疗;不良事件的管理(血液学影响,胃肠道的影响,肾脏影响,肺效应,皮肤效应,高血压,失眠,疲劳,头晕);特殊人群和情况;与患者沟通;依从性。经过3轮投票后,有49项声明获得了选民共识。血液学家和肾病学家通过起草关于继发性白血病和肾病毒性发生风险的专家意见来补充这项任务。
结论:本文是关于PARP抑制剂实际管理的第一个Delphi共识。本文提出的务实建议应该可以更好地管理PARP抑制剂的副作用,从而防止早期停药,并通过保持生活质量来提高患者的依从性。