skip to main content

Prostate Cancer — SCE Medical Oncology MCQ

Instant feedback + full explanation. One question, done properly.

ModerateUrological CancersProstate CancerSCE Medical Oncology

A 65-year-old man with mCRPC and homozygous BRCA2 deletion is started on olaparib. He develops grade 3 anaemia (Hb 72 g/L) requiring transfusion after 6 weeks. What is the appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Hold olaparib, transfuse, and resume at a reduced dose (250 mg BD then 200 mg BD) when Hb recovers

Anaemia is the most common haematological toxicity of PARP inhibitors (occurring in 20-40% of patients, grade 3 in approximately 10-15%). Management includes treatment interruption, blood transfusion, and dose reduction (olaparib: 300mg BD → 250mg BD → 200mg BD). Persistent grade 3 anaemia despite dose reduction requires discontinuation. MDS/AML should be excluded with blood film and reticulocyte count if anaemia is persistent or accompanied by other cytopenias.

Reference: BNF Olaparib monograph; NICE TA887 Olaparib mCRPC; ESMO 2024 Prostate Cancer Guidelines