Case Review: Ovarian Cancer and the Initial Treatment Options

Maintenance and Recurrent Treatment Options for Ovarian Cancer

Choices for Second-Line Maintenance Therapy

Combination Therapy With Niraparib and Bevacizumab for Ovarian Cancer

Case:  A 58-Year-Old Female With Progressive Ovarian Cancer

A 58-year-old female presents to the clinic for bloating, pelvic pain, early satiety, and urinary urgency. She reports intolerance to strenuous activity at the gym for the past four months but is still able to carry out daily activities such as work, and house chores.

PE: controlled HTN, abdominal distension;

CT with contrast of the pelvis, abdomen, and chest reveals bilateral serous cystadenocarcinomas

Pathology: high-grade serous carcinoma, epithelial ovarian cancer

Patient underwent hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and tumor debulking

Received IV paclitaxel and carboplatin and bevacizumab, 6 cycles

CA-125, 43 U/mL upon completion of 6 cycles chemotherapy

Ten months later at routine follow up, patient presented with recurring symptoms; CA-125, 565 U/mL

Started on carboplatin/paclitaxel for 6 cycles plus bevacizumab

Patient achieved a partial response, started on niraparib maintenance therapy

CBC: WNL, SCr: 0.8, AST: 10 u/L, ALT: 7 u/L, and ANC: 1.7 x 10