First-Line PARPi Maintenance in Advanced Ovarian Cancer
First-Line PARPi Maintenance in Advanced Ovarian Cancer
Case: A 54-Year-Old Female With Ovarian Cancer
H & P
- 54-year-old female presents with abdominal pain and bloating
- Pathology: High-grade, stage III, epithelial ovarian cancer of the right ovary, and positive for numerous small (<0.7cm) pelvic and para-aortic lymph nodes disease
- CA-125, 305 U/mL
- Imaging
- CT with contrast of the pelvis, abdomen, and chest revealed a right adnexal 2.9-cm mass, no ascites or pleural effusion noted
- Treatment
- Patient underwent exploratory laparotomy with unilateral salpingo-oophorectomy, pelvic and para-aortic lymph node dissection
- Status post-surgery: macroscopic residual disease (R2), 1.2cm lesion
- Received second cytoreduction surgery
- Germline molecular testing showed HRD +,BRAC1alteration
- Initiated IV/IP paclitaxel/cisplatin
- Initial post treatment CA 125, 48 U/mL
- Started on niraparib maintenance therapy
- Patient underwent exploratory laparotomy with unilateral salpingo-oophorectomy, pelvic and para-aortic lymph node dissection
- Follow-up:
- CA 125, 25 U/mL upon completion of chemotherapy (6 cycles)
- CT at 2.5 months post-surgery, no gross pelvic masses; chest CT unremarkable
- Unremarkable pelvic exam
- ECOG: 0
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