Department of Gynaecologic and Breast Oncological Surgery, European Georges-Pompidou Hospital, APHP. Centre, 20, rue Leblanc, 75908, Paris Cedex 15, France.
Faculty of Medicine, Paris University, Paris, France.
J Med Case Rep. 2021 Apr 23;15(1):210. doi: 10.1186/s13256-021-02767-9.
Homologous recombination deficiency is a marker of response to poly(ADP-ribose) polymerase inhibitors in different cancer types including ovary, prostate, and pancreatic cancer. To date, no report about poly(ADP-ribose) polymerase inhibitors has been published on cervical cancer.
Here we present the case of a patient with cervical cancer treated in this setting. A 49-year-old woman diagnosed with International Federation of Obstetricians and Gynecologists stage 2018 IIIC2 locally advanced undifferentiated cervical cancer received first-line chemoradiotherapy followed by carboplatin, paclitaxel, and bevacizumab with partial response. Because of a family history of cancers, the patient was tested and found positive for a pathogenic BRCA1 germline and somatic mutation, which motivated bevacizumab plus olaparib maintenance treatment. A simple hysterectomy was performed after 2 years stable disease; pathological report showed complete pathological response, and 12 months follow-up showed no recurrence.
Poly(ADP-ribose) polymerase inhibitors could be an alternative maintenance treatment for patients with persistent advanced cervical cancer previously treated with platinum, especially when familial history of cancers is reported. Clinical trials using poly(ADP-ribose) polymerase inhibitors for advanced cervical cancer are warranted.
同源重组缺陷是不同癌症类型（包括卵巢癌、前列腺癌和胰腺癌）对聚（ADP-核糖）聚合酶抑制剂反应的标志物。迄今为止，尚无关于聚（ADP-核糖）聚合酶抑制剂在宫颈癌中应用的报道。
本研究报告了一名按此方案治疗的宫颈癌患者。一名 49 岁女性被诊断为国际妇产科联合会 2018 年分期的局部晚期未分化宫颈癌 IIIC2 期，接受了一线放化疗，随后接受了卡铂、紫杉醇和贝伐珠单抗治疗，部分缓解。由于癌症家族史，该患者进行了检测，发现存在致病性 BRCA1 种系和体细胞突变，这促使其接受贝伐珠单抗联合奥拉帕利维持治疗。2 年后疾病稳定时进行了单纯子宫切除术；病理报告显示完全病理缓解，12 个月的随访未发现复发。
对于先前接受铂类药物治疗的持续性晚期宫颈癌患者，聚（ADP-核糖）聚合酶抑制剂可能是一种替代维持治疗方法，尤其是当报告有癌症家族史时。需要开展聚（ADP-核糖）聚合酶抑制剂治疗晚期宫颈癌的临床试验。
