Bredow Kathrin, Blümcke Britta, Schneider Stephanie, Püsken Michael, Schmutzler Rita, Rhiem Kerstin
Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), Medical Faculty, University of Cologne and University Hospital Cologne, D-50931 Cologne, Germany.
Department of Gynecology and Gynecologic Oncology, Evang. Kliniken Essen Mitte, D-45136 Essen, Germany.
Mol Clin Oncol. 2022 Jul 21;17(3):137. doi: 10.3892/mco.2022.2570. eCollection 2022 Sep.
mutation carriers have lifelong increased risks of developing breast and ovarian cancer. Due to the lack of efficient ovarian cancer screening, patients mainly present when the tumors are at an advanced stage, and the long-term survival is poor. The application of poly(ADP-ribose) polymerase (PARP) inhibitors (PARPi) has been used in personalized cancer treatment. Specific strategies to improve the outcome of patients are available and mainly include targeting of 1 or mutations. The aim of the present study was to report the case of a 67-year old mutation carrier, who was enrolled in 2010 in one of the first PARPi studies (ICEBERG2). The patient exhibited second ovarian cancer (OC) relapse following a platinum-free interval of 5 months. The third-line treatment with olaparib monotherapy was initiated in January 2011, without prior surgery or chemotherapy, and achieved a persistent response. The patient demonstrated an unprecedented long-term survival of >9 years under PARPi monotherapy after the second relapse of OC. The data of the present case report support the use of PARPi as a well-tolerated and effective long-term treatment, even for patients with unfavourable prognostic characteristics, such as platinum resistance, without immediately preceding optimal cytoreduction. However, further studies are required to provide more insight into the selection of patients for favourable maintenance treatment.
突变携带者患乳腺癌和卵巢癌的终身风险增加。由于缺乏有效的卵巢癌筛查,患者主要在肿瘤处于晚期时才出现,长期生存率较差。聚(ADP-核糖)聚合酶(PARP)抑制剂(PARPi)已应用于个性化癌症治疗。有一些改善患者预后的具体策略,主要包括针对一种或多种突变。本研究的目的是报告一名67岁的突变携带者的病例,该患者于2010年参加了首批PARPi研究之一(ICEBERG2)。该患者在无铂间期5个月后出现第二次卵巢癌(OC)复发。2011年1月开始使用奥拉帕利单药进行三线治疗,未进行过手术或化疗,并取得了持续缓解。该患者在OC第二次复发后接受PARPi单药治疗,显示出超过9年的前所未有的长期生存。本病例报告的数据支持PARPi作为一种耐受性良好且有效的长期治疗方法的使用,即使对于具有不利预后特征(如铂耐药)且没有立即进行最佳细胞减灭术的患者也是如此。然而,需要进一步研究以更深入了解适合维持治疗的患者选择。