A case report of long-term successful use of maintenance therapy with PARP inhibitors in the primary treatment of advanced BRCA-associated ovarian cancer
https://doi.org/10.21294/1814-4861-2023-22-4-135-141
Abstract
Background. Ovarian cancer is the third most common cancer of the female reproductive system after cervical and uterine cancer and is diagnosed at stage III–IV in 2 out of 3 cases. Maintenance therapy with PARP inhibitors signifcantly prolongs disease-free and overall survival.
The purpose of the study was to demonstrate long-term remission in a patient with advanced ovarian cancer using maintenance therapy with PARP inhibitors (olaparib).
Description of the clinical case. A 54-year-old female patient with verifed stage IV ovarian cancer, peritoneal carcinomatosis and left-sided pleurisy received combined modality treatment, including 2 courses of neoadjuvant chemotherapy with paclitaxel/carboplatin, cytoreductive surgery and 6 courses of postoperative chemotherapy with docetaxel/cisplatin. The patient was diagnosed with a somatic BRCA2 gene mutation (c.3708delA), which was detected by tumor DNA sequencing. The patient received maintenance therapy with olaparib for 38 months, resulting in no evidence of disease progression.
Conclusion. This clinical case demonstrates the feasibility of using maintenance therapy with PARP inhibitors in a patient with initially disseminated platinum-sensitive ovarian cancer. Olaparib maintenance therapy provides stable long-term remission with no signs of adverse events and determined effect on quality of life of the patient.
About the Authors
О. N. Churuksaeva
Cancer Research Institute, Тomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation
Russian Federation
Olga N. Churuksaeva, MD, DSc, Senior Researcher, Department of Gynecological Oncology,
Researcher ID (WOS): C-8601-2012. Author ID (Scopus): 6504391579
5, Kooperativny St., 634009, Tomsk
L. А. Kolomiets
Cancer Research Institute, Тomsk National Research Medical Center, Russian Academy of Sciences;
Siberian State Medical University of the Ministry of Health of Russia
Russian Federation
Russian Federation
Larisa A. Kolomiets, MD, Professor, Head of Gynecological Oncology Department; Professor of the Department of Oncology,
Researcher ID (WOS): C-8573-2012. Author ID (Scopus): 7004921120
5, Kooperativny St., 634009, Tomsk;
2, Moskovsky tract, 634050, Tomsk
А. B. Villert
Cancer Research Institute, Тomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation
Russian Federation
Alisa B. Villert, MD, PhD, Senior Researcher,
Researcher ID (WOS): J-3140-2017. Author ID (Scopus): 16039933700
5, Kooperativny St., 634009, Tomsk
References
1. Seledtsov V.I., Seledtsova G.V., Dorzhieva A.B., Ivanova I.P. Immunotherapy in the complex treatment of tumor diseases. Siberian Journal of Oncology. 2022; 21(2): 118–29. (in Russian). doi: 10.21294/1814-4861-2022-21-2-118-129.
2. Mullen M.M., Kuroki L.M., Thaker P.H. Novel treatment options in platinum-sensitive recurrent ovarian cancer: A review. Gynecol Oncol. 2019; 152(2): 416–25. doi: 10.1016/j.ygyno.2018.10.023.
3. Kurnit K.C., Fleming G.F., Lengyel E. Updates and New Options in Advanced Epithelial Ovarian Cancer Treatment. Obstet Gynecol. 2021; 137(1): 108–21. doi: 10.1097/AOG.0000000000004173.
4. Endo S., Shigeta S., Tokunaga H., Shimizu T., Hasegawa-Minato J., Hashimoto C., Ishibashi M., Nagai T., Shiga N., Shimada M., Yaegashi N. A Retrospective Analysis of Clinical Biomarkers for Olaparib Maintenance Therapy in Patients with Recurrent Ovarian Cancer. Tohoku J Exp Med. 2022; 258(1): 1–9. doi: 10.1620/tjem.2022.J050.
5. Ledermann J., Harter P., Gourley C., Friedlander M., Vergote I., Rustin G., Scott C.L., Meier W., Shapira-Frommer R., Safra T., Matei D., Fielding A., Spencer S., Dougherty B., Orr M., Hodgson D., Barrett J.C., Matulonis U. Olaparib maintenance therapy in patients with platinum-sensitive relapsed serous ovarian cancer: a preplanned retrospective analysis of outcomes by BRCA status in a randomised phase 2 trial. Lancet Oncol. 2014; 15(8): 852–61. doi: 10.1016/S1470-2045(14)70228-1. Erratum in: Lancet Oncol. 2015; 16(4).
6. Bartoletti M., Pelizzari G., Gerratana L., Bortot L., Lombardi D., Nicoloso M., Scalone S., Giorda G., Baldassarre G., Sorio R., Puglisi F. Bevacizumab or PARP-Inhibitors Maintenance Therapy for PlatinumSensitive Recurrent Ovarian Cancer: A Network Meta-Analysis. Int J Mol Sci. 2020; 21(11): 3805. doi: 10.3390/ijms21113805.
7. González-Martín A., Pothuri B., Vergote I., DePont Christensen R., Graybill W., Mirza M.R., McCormick C., Lorusso D., Hoskins P., Freyer G., Baumann K., Jardon K., Redondo A., Moore R.G., Vulsteke C., O’Cearbhaill R.E., Lund B., Backes F., Barretina-Ginesta P., Haggerty A.F., Rubio-Pérez M.J., Shahin M.S., Mangili G., Bradley W.H., Bruchim I., Sun K., Malinowska I.A., Li Y., Gupta D., Monk B.J.; PRIMA/ENGOTOV26/GOG-3012 Investigators. Niraparib in Patients with Newly Diagnosed Advanced Ovarian Cancer. N Engl J Med. 2019; 381(25): 2391–2402. doi: 10.1056/NEJMoa1910962.
8. Coleman R.L., Fleming G.F., Brady M.F., Swisher E.M., Steffensen K.D., Friedlander M., Okamoto A., Moore K.N., Efrat Ben-Baruch N., Werner T.L., Cloven N.G., Oaknin A., DiSilvestro P.A., Morgan M.A., Nam J.H., Leath C.A., Nicum S., Hagemann A.R., Littell R.D., Cella D., Baron-Hay S., Garcia-Donas J., Mizuno M., Bell-McGuinn K., Sullivan D.M., Bach B.A., Bhattacharya S., Ratajczak C.K., Ansell P.J., Dinh M.H., Aghajanian C., Bookman M.A. Veliparib with First-Line Chemotherapy and as Maintenance Therapy in Ovarian Cancer. N Engl J Med. 2019; 381(25): 2403–15. doi: 10.1056/NEJMoa1909707.
9. Khokhlova S.V. New in the treatment of high-grade serous ovarian cancer. Efective Pharmacotherapy. 2019; 15(38): 24–9. (in Russian). doi: 10.33978/2307-3586-2019-15-38-24-29.
10. Jelovac D., Armstrong D.K. Recent progress in the diagnosis and treatment of ovarian cancer. CA Cancer J Clin. 2011; 61(3): 183–203. doi: 10.3322/caac.20113.
11. Friedrich M., Friedrich D., Kraft C., Rogmans C. Multimodal Treatment of Primary Advanced Ovarian Cancer. Anticancer Res. 2021; 41(7): 3253–60. doi: 10.21873/anticanres.15111.
12. Bolton K.L., Chenevix-Trench G., Goh C., Sadetzki S., Ramus S.J., Karlan B.Y., Lambrechts D., Despierre E., Barrowdale D., McGuffog L., Healey S., Easton D.F., Sinilnikova O., Benítez J., García M.J., Neuhausen S., Gail M.H., Hartge P., Peock S., Frost D., Evans D.G., Eeles R., Godwin A.K., Daly M.B., Kwong A., Ma E.S., Lázaro C., Blanco I., Montagna M., D’Andrea E., Nicoletto M.O., Johnatty S.E., Kjær S.K., Jensen A., Høgdall E., Goode E.L., Fridley B.L., Loud J.T., Greene M.H., Mai P.L., Chetrit A., Lubin F., Hirsh-Yechezkel G., Glendon G., Andrulis I.L., Toland A.E., Senter L., Gore M.E., Gourley C., Michie C.O., Song H., Tyrer J., Whittemore A.S., McGuire V., Sieh W., Kristoffersson U., Olsson H., Borg Å., Levine D.A., Steele L., Beattie M.S., Chan S., Nussbaum R.L., Moysich K.B., Gross J., Cass I., Walsh C., Li A.J., Leuchter R., Gordon O., Garcia-Closas M., Gayther S.A., Chanock S.J., Antoniou A.C., Pharoah P.D.; EMBRACE; kConFab Investigators; Cancer Genome Atlas Research Network. Association between BRCA1 and BRCA2 mutations and survival in women with invasive epithelial ovarian cancer. JAMA. 2012; 307(4): 382–90. doi: 10.1001/jama.2012.20.
13. Pokataev I.A. The place of PARP inhibitors in the treatment of recurrent ovarian cancer. Oncogynecology. 2017; (4): 37–46. (in Russian).
14. Helleday T., Petermann E., Lundin C., Hodgson B., Sharma R.A. DNA repair pathways as targets for cancer therapy. Nat Rev Cancer. 2008; 8(3): 193–204. doi: 10.1038/nrc2342.
15. Ledermann J.A. PARP inhibitors in ovarian cancer // PARP inhibitors in ovarian cancer. Ann Oncol. 2016; 27 (s1): 40–4. doi: 10.1093/annonc/mdw094.
16. Moore K., Colombo N., Scambia G., Kim B.G., Oaknin A., Friedlander M., Lisyanskaya A., Floquet A., Leary A., Sonke G.S., Gourley C., Banerjee S., Oza A., González-Martín A., Aghajanian C., Bradley W., Mathews C., Liu J., Lowe E.S., Bloomfeld R., DiSilvestro P. Maintenance Olaparib in Patients with Newly Diagnosed Advanced Ovarian Cancer. N Engl J Med. 2018; 379(26): 2495–2505. doi: 10.1056/NEJMoa1810858.
17. DiSilvestro P., Colombo N., Scambia G., Kim B.G., Oaknin A., Friedlander M., Lisyanskaya A., Floquet A., Leary A., Sonke G.S., Gourley C., Banerjee S., Oza A., González-Martín A., Aghajanian C.A., Bradley W.H., Mathews C.A., Liu J., Lowe E.S., Bloomfeld R., Moore K.N. Efcacy of Maintenance Olaparib for Patients With Newly Diagnosed Advanced Ovarian Cancer With a BRCA Mutation: Subgroup Analysis Findings From the SOLO1 Trial. J Clin Oncol. 2020; 38(30): 3528–37. doi: 10.1200/JCO.20.00799. Erratum in: J Clin Oncol. 2021; 39(12): 1414.
18. Poveda A., Floquet A., Ledermann J.A., Asher R. Final overall survival results from SOLO2/ENGOT-ov21: a Phase III trial assessing maintenance olaparib in patients with platinum-sensitive, relapsed ovarian cancer and a BRCA mutation. J Clin Oncol. 2020; 38(15s): 6002. doi: 10.1200/JCO.2020.38.15_suppl.6002.
19. Fong P.C., Boss D.S., Yap T.A., Tutt A., Wu P., Mergui-Roelvink M., Mortimer P., Swaisland H., Lau A., O’Connor M.J., Ashworth A., Carmichael J., Kaye S.B., Schellens J.H.M., de Bono J.S. Inhibition of Poly(ADPRibose) Polymerase in Tumors from BRCA Mutation Carriers. N Engl J Med. 2009; 361: 123–34. doi: 10.1056/NEJMoa0900212.
20. Penson R.T., Valencia R.V., Cibula D., Colombo N., Leath C.A., Bidziński M., Kim J.W., Nam J.H., Madry R., Hernández C., Mora P.A.R., Ryu S.Y., Milenkova T., Lowe E.S., Barker L., Scambia G. Olaparib Versus Nonplatinum Chemotherapy in Patients With Platinum-Sensitive Relapsed Ovarian Cancer and a Germline BRCA1/2 Mutation (SOLO3): A Randomized Phase III Trial. J Clin Oncol. 2020; 38(11): 1164–74. doi: 10.1200/JCO.19.02745.
Review
For citations:
Churuksaeva О.N., Kolomiets L.А., Villert А.B. A case report of long-term successful use of maintenance therapy with PARP inhibitors in the primary treatment of advanced BRCA-associated ovarian cancer. Siberian journal of oncology. 2023;22(4):135-141. (In Russ.) https://doi.org/10.21294/1814-4861-2023-22-4-135-141
Views:
797
Email this article 
