Roy Somnath, Ghosh Joydeep, Ganguly Sandip, Biswas Bivas, Bhaumik Jaydip
Department of Medical Oncology, Tata Medical Center, Kolkata, IND.
Department of Gynaecological Oncology, Tata Medical Center, Kolkata, IND.
Cureus. 2022 Dec 13;14(12):e32493. doi: 10.7759/cureus.32493. eCollection 2022 Dec.
The present case study showed the novel approach of Rucaparib and Bevacizumab as first-line maintenance therapy in germline BRCA 1 mutated advanced high-grade serous carcinoma of the ovary. A 56-year-old female with high-grade serous carcinoma of the ovary (ECOG PS1) was treated with carboplatin and paclitaxel in combination with Bevacizumab (CPB), followed by interval debulking surgery. Since the patient was germline BRCA 1 positive, after completion of adjuvant chemotherapy, she was kept on Rucaparib along with Bevacizumab. The patient achieved a complete response and has been leading a disease-free life for the past one year with maintenance therapy of Rucaparib + Bevacizumab, though the patient did experience a few adverse events, including one episode of grade 3 anaemia, occasional grade 3 asthenia, and grade 2 diarrhoea (CTCAE V-4) which was managed by gradual dose reduction of Rucaparib from 600 mg twice daily dose to 300mg twice daily dose. With dose alteration of rucaparib along with bevacizumab as maintenance, the patient continues to tolerate rucaparib and stay relapse-free from disease.
本病例研究展示了芦卡帕尼和贝伐单抗作为种系BRCA 1突变的晚期高级别浆液性卵巢癌一线维持治疗的新方法。一名56岁的卵巢高级别浆液性癌女性患者(东部肿瘤协作组体能状态评分为1)接受了卡铂、紫杉醇联合贝伐单抗(CPB)治疗,随后进行了间隔减瘤手术。由于该患者种系BRCA 1呈阳性,在辅助化疗完成后,她继续接受芦卡帕尼联合贝伐单抗治疗。该患者实现了完全缓解,在过去一年中通过芦卡帕尼+贝伐单抗维持治疗一直处于无病状态,尽管该患者确实经历了一些不良事件,包括1次3级贫血、偶尔出现的3级乏力以及2级腹泻(美国国立癌症研究所不良事件通用术语标准第4版),这些通过将芦卡帕尼的每日剂量从600毫克两次逐渐减至300毫克两次进行处理。随着芦卡帕尼与贝伐单抗剂量调整作为维持治疗,该患者继续耐受芦卡帕尼且疾病无复发。