Case: A 69-year-old Woman with Advanced Serous Ovarian Cancer
January 2017
- A 69-year-old Caucasian woman presented to the emergency department with shortness of breath
- PMH: mild HTN and DM, medically managed; morbid obesity
- PE: large volume ascites
- CT angiography (chest) showed large bilateral pulmonary effusions, no pulmonary thromboembolism
- Laboratory findings remarkable for CA 125, 525U/mL
- Thoracentesis (1500 cc); cytology showed high grade adenocarcinoma
- Paracentesis (4500 cc); cytology showed high grade adenocarcinoma
- Core biopsy of omentum; high grade serous carcinoma; p53 (+)/ PAX 8 (+) /WTI and CX 7 (+); BRCA1/2 wild-type
- The patient underwent debulking surgery with incomplete cytoreduction
- She was treated as part of a clinical trial with carboplatin/paclitaxel + bevacizumab followed by continuous bevacizumab maintenance
April 2018
- Fifteen months later, the patients complained of severe abdominal bloating and fatigue
- Imaging showed multifocal recurrence within the abdominal cavity
- She was started on carboplatin/docetaxel
- After 6 cycles of therapy she had a partial response to therapy with bulky residual disease
- She was initiated on rucaparib maintenance therapy, 600 mg BID
- Hb fell to 7.2 g/dl, managed with treatment interruption and then dose reduction to rucaparib 500 mg