Rubraca (rucaparib)

Reviewed by: HU Medical Review Board

The United States Food and Drug Administration has approved Rubraca (rucaparib) for certain forms of metastatic castration-resistant prostate cancer (mCRPC). This means, a person’s cancer has spread to other parts of their body and has not responded to surgery or drugs that lower testosterone. Rucaparib was granted accelerated approval by the US FDA. This happens when results from clinical trials are promising, and the FDA allows a drug to be available sooner than usual, with ongoing studies to confirm the benefit of the medication.

Specifically, rucaparib is for adults with a specific mutation in their cancer cells called the BRCA mutation. Your doctor will likely run a genetic test to determine if your cancer falls into this category. In addition to the BRCA mutation, people taking rucaparib must also have previously been treated with therapy aimed at androgen receptors and a type of chemotherapy called a taxane. Rucaparib is also used for certain cases of ovarian cancer.

How does rucaparib work?

PARP (poly ADP-ribose polymerase) inhibitors block a protein that is involved in repairing and making DNA in cells. By interfering with this protein, PARP inhibitors may cause enough damage to certain cells that they eventually die. Cancer cells, including prostate cancer cells that have the BRCA gene mutation, may respond to these PARP inhibitors. By causing the death of these cells, it may be possible to slow the growth of tumors or their spread.

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What are the possible side effects of rucaparib?

For people taking rucaparib for prostate cancer, the most common side effects include:

  • Fatigue
  • Nausea and vomiting
  • Constipation or diarrhea
  • Decreased appetite
  • Low red blood cell counts (anemia)
  • Rash
  • Changes in liver function or liver function tests
  • Low platelet count, which can increase the risk of bleeding and bruising

 

This is not a full list of all potential side effects. Your doctor can provide you with more information on rucaparib.

Things to know about rucaparib

As with other drugs, there are less common but serious side effects that can occur with rucaparib. Rucaparib may cause issues with a person’s bone marrow. This includes a potential increased risk of developing blood cancers known as myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). If you develop one of these conditions, rucaparib treatment will need to be stopped. Possible signs of problems with your blood cells include:

  • Severe weakness
  • Weight loss
  • Fever
  • Frequent infections
  • Shortness of breath
  • Bruising easily

If you notice any of these signs, contact your doctor as soon as possible. Since rucaparib can lower the number of certain blood cells, your doctor will need to monitor your blood counts regularly.

Rucaparib may harm an unborn baby. Because of this, men being treated for prostate cancer who have female partners who could become pregnant, or who are pregnant, should utilize effective birth control methods while taking rucaparib and for a period of time after stopping the drug. Patients should discuss appropriate birth control methods with their doctor.

Before starting rucaparib for prostate cancer, tell your doctor if you:

  • Have any other health conditions
  • Have a partner who is pregnant or who may become pregnant
  • Are taking any other medications (prescription and over-the-counter), vitamins, or supplements

Your doctor will determine the appropriate dosage and administration schedule for you. It is important to follow this schedule exactly as instructed, and not to stop taking rucaparib or any other prescribed medications on your own. Patients should take their medication as prescribed by their doctor. Patients should talk to their doctor if they have any questions, or if they have questions regarding their rucaparib regimen.

Read the prescribing information for rucaparib to learn more.1,2These are not all the possible side effects of rucaparib. Talk to your doctor about what to expect or if you experience any changes that concern you during treatment with rucaparib.