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Gynecologic Cancer Case Studies

Case Studies: Heavily Pretreated Recurrent Ovarian Cancer

Kathleen Moore, MD, reacts to her impressions of a case of female with advanced ovarian cancer who progresses through various lines of treatment and explains how she would approach the case in the era of targeted therapies.

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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