A 71-Year-Old Woman With High-Risk Ovarian Cancer

July 14, 2020

Ramez N. Eskander, MD, explains the rationale for treating a 71-year-old woman with ovarian cancer with the PARP inhibitor rucaparib upon relapse.


Case: A 71-Year Old Woman With High-Risk Ovarian Cancer

Initial presentation

  • A 71-year old woman presented to her PCP for a routine annual checkup, she complains of increasing fatigue
  • PMH:
    • Hypertension, controlled on a thiazide
    • 2017 diagnosed with stage IV ovarian cancer; BRCAwt; underwent TAH/BSO, lymph node dissection, with suboptimal debulking; treated with paclitaxel/carboplatin/bevacizumab followed by maintenance bevacizumab; achieved CR

Currently

  • CA-125, 456 U/mL
  • Chest/abdomen/pelvis CT with contrast shows a suspicious lung lesion
    • Lung biopsy confirmed recurrent epithelial ovarian cancer
  • Molecular testing showed HRD+, LOH high
  • ECOG: 0


Treatment and Follow-Up

  • She was started referred to an oncologist and started on carboplatin/doxorubicin, treatment was well tolerated for 4 cycles; CA-125 35 U/mL;
    • Rucaparib 300 mg BID maintenance was initiated
  • At 2 months follow-up
    • CA-125 was undetectable
    • Chest/abdomen/pelvis CT showed no gross masses or nodes
    • Pelvic exam was unremarkable