A 67-Year-Old Woman With Ovarian Cancer
Chirag Shah, MD, MPH, an expert in gynecologic oncology, reviews the case of a 67-year-old woman with ovarian cancer and discusses factors to consider when selecting therapy including the recent results of the PRIMA and NOVA trials of niraparib in patients with ovarian cancer.
Case: A 67-Year-Old Woman With Ovarian Cancer
Initial Presentation
- A 67-year-old female presented with abdominal discomfort and modest weight loss
- PMH: unremarkable, postmenopausal; no known family history of cancer
- PE: diffuse tenderness to abdominal palpation, abdominal bloating
- ECOG PS 0
Clinical Work-up
- Pelvic exam with transvaginal ultrasound showed a left ovarian mass
- Chest/abdomen/pelvis CT with contrast revealed a left adnexal 5-cm mass, pelvic and inguinal lymph node involvement, no pleural effusion
- Paracentesis (1200cc) cytology confirmed high-grade epithelial ovarian cancer
- Germline molecular testing: HRD+, BRCA1/2-
- CA-125, 360 U/mL
- Diagnosis: Stage 4, high-grade epithelial ovarian cancer
Treatment
- Patient underwent TAH/BSO, lymph node dissection, with optimal debulking; R0
- IP/IV paclitaxel/cisplatin; CR
- Niraparib maintenance was initiated
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