Tolerance of Olaparib in a Patient With Unresectable Serous Gynecologic Cancer and End-Stage Renal Disease

Poly (adenosine diphosphate-ribose) polymerase enzyme (PARP) inhibitors have risen in popularity for the treatment of gynecologic cancers, largely due to an expansion of applications with the discovery of more genetic mutations that manifest as homologous recombination deficiency. PARP inhibitors further represent an appealing management option as oral maintenance or monotherapy. While dose adjustments exist for mild kidney dysfunction, little is published about the use of PARP inhibitors in patients with severe renal dysfunction. We present a case of advanced, serous gynecologic cancer in a patient who was ineligible for surgery due to cardiac and renal comorbidities and treated with olaparib for nine months without direct adverse effects, despite a paucity of literature supporting the use or dosing of olaparib in patients requiring dialysis. Further studies are needed to better establish the safety, efficacy, and appropriate dose modification for patients with end-stage renal disease.