Analysis of olaparib-induced hyperglycemia during three-month therapy with consideration of BMI of ovarian cancer patients

Abstract

Introduction. Olaparib is a relatively new poly(ADP-ribose) polymerase inhibitor administered to patients with ovarian cancer (OC) with a complete or partial response to first-line chemotherapy. One of the metabolic side effects of olaparib is disruption of glucose homeostasis, resulting in hyperglycemia Aim. The aim of the study was the retrospective analysis of olaparib-induced hyperglycemia in OC patients with initial normoglycemia following I, II, and III cycle of olaparib treatment. Methods. The study involved 32 OC patients, divided into three groups according to their BMI: normal BMI (BMI 18.5-24.9 kg/m2; n=13), overweight (BMI 25-29.9 kg/m2; n=13), and obesity (BMI ≥30 kg/m2; n=6). The fasting glucose (FG) levels were evaluated after I, II, and III cycle of olaparib treatment (a cycle means 28 days of olaparib treatment). The severity of observed hyperglycemia was assessed using the Common Terminology Criteria for Adverse Events (CTCAE v5.0). Results. In the group with normal BMI, the increase of glycemia was statistically significant after I (p=0.0032) and II (p=0.0195) cycle of olaparib treatment, in the group with overweight – after III (p=0.0375) cycle, and in the group with obesity – after III cycle (p=0.0152). There were no statistically significant differences in glucose levels among the groups following I (p=0.7741), II (p=0.9418) and III cycle (p=0.3431). During olaparib treatment, grade 1 hyperglycemia with impaired fasting glucose levels (5.6–6.9 mmol/l) was found in 15 patients ( normal BMI: n=4, overweight n=9, and obesity n=2). Glycemia typical of diabetes (≥7.0 mmol/l) was observed in 1 obese patients. Conclusions. Regardless of the weight of OC patients, glycemic control in the course of olaparib treatment is indicated.