Lynparza (Olaparib) is not chemotherapy. Chemotherapy drugs work by interrupting the DNA cell cycle. Olaparib is a PARP-1 inhibitor used as maintenance monotherapy by inhibiting the enzyme PARP which is necessary for catalyzing the repair of broken stands of DNA. When there is inhibition of DNA strand repair, the cell undergoes apoptosis and dies.

I take the biosimilar PARP inhibitor Rubraca (Rucaparib) over 8.5 years now as the longest pancrecancer patient in the world on it. At exactly six years is when I began to feel fatigued. A characteristic of all PARP inhibitors is the suppressions of bone marrow precursor cells that become RBC’s when they mature and reach the circulation. A pause of 4 weeks and then restarting at the first dose reduction has made it more tolerable and my RBC and Hgb levels, while still in the range for anemia, are sufficient to reduce the fatigue. I try to be diligent at exercising daily by walking several miles. For inclement weather, I invested in a stationary exercise bike. The one dose reduction and keeping up with moderate exercise has helped with stamina and endurance. I still have leeway in doing another dose reduction should the anemia and it’s symptoms increase.