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Gynecologic Cancer Case Studies

Case Studies: Managing A Case of Heavily Pretreated Recurrent Ovarian Cancer

Thomas Krivak, MD, reviews the case of a 58-year-old diagnosed with stage IV ovarian cancer and shares treatments options.

Managing A Case of Heavily Pretreated Recurrent Ovarian Cancer

Case:  A 58-Year-Old Female With Heavily Pretreated Recurrent Ovarian Cancer

H & P

  • 58-year-old female diagnosed in 2014 with stage IV ovarian cancer
    • Pathology: high-grade serous carcinoma, epithelial ovarian cancer
    • CA-125: 460 U/mL
    • CT with contrast of the pelvis, abdomen, and chest revealed a 4-cm mass in the left ovary and peritoneal carcinomatosis
    • Patient underwent suboptimal debulking surgery; residual disease 1.5 cm
    • Received IV/IP carboplatin/paclitaxel (6 cycles); achieved complete remission
  • 2 years later (2016) symptoms returned; CA 125, 255 U/mL; ECOG: 1
    • Received carboplatin/paclitaxel (6 cycles) and bevacizumab; achieved good partial remission; CA 125, 45 U/mL; continued on bevacizumab maintenance
  • 1.5-years following second-line therapy (2017), again presented with symptoms; CA 125, 550 U/mL; ECOG: 0
    • Genetic testing; gBRCA1/2 wild-type
    • Received carboplatin/gemcitabine (6 cycles); CA 125, 46 U/mL; achieved complete remission
  • Currently:
    • CA 125, 620 U/mL
    • CT shows several small masses in the lung left lower lobe (largest is 3 cm)
    • ECOG: 0
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