ONCAlert | 2018 SGO Annual Meeting on Women’s Cancer
Gynecologic Cancer Case Studies

Case Studies: Management of Platinum-Resistant Ovarian Cancer

In this case-based interview, Robert L. Coleman, MD, provides an overview on the therapeutic management for a patient who presents with metastatic platinum-resistant ovarian cancer.

Management of Platinum-Resistant Ovarian Cancer

July 2016

  • A 38-year old female presented to her gynecologist with abdominal distension, abdominal pain, fullness after eating, and increased urination frequency for 2 months
    • Pelvic examination revealed a suspicious mass on the left ovary
  • Laboratory findings:
    • CA-125: 785 U/ml
    • Genetic testing for BRCA1/2, negative
  • CT with contrast of the pelvis, abdomen, and chest indicated widespread peritoneal lesions
  • She was referred to gynecologic oncology and underwent hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and tumor debulking; She had diffuse studding in the omentum and diaphragmatic surfaces
  • Stage 3C ovarian cancer
  • She achieved complete removal of gross residual disease (R0)
  • Pathology, high-grade endometrioid adenocarcinoma, ovarian primary
  • The patient was started on therapy with carboplatin and every-3-weekly paclitaxel

October 2016

  • Post-treatment assessment revealed no evidence of disease

March 2017

  • Patient complained of fatigue and chest pain
  • Physical examination:
    • Lungs, moist rales bilaterally
    • Abdomen, shifting dullness
  • Laboratory findings: CA-125: 1,052 U/ml
  • CT imaging: left-sided pleural effusion and sclerotic lesions in the lung apical region, ascites, new hypodense lesions in the right lobe of the liver and enlarged retroperitoneal nodes were considered metastatic
  • She was started on therapy with weekly paclitaxel and bevacizumab
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