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testxlog

Ovarian cancer recurrence, multiple abdominal metastases, allergic to carboplatin, resistant to cisplatin, ineffective with olaparib, niraparib, and bevacizumab, what to do?

I. Brief Introduction of the Condition#

  • Female, 76 years old, discovered a large pelvic mass 6 years ago, sought medical attention for abdominal distension.
  • Pathological puncture confirmed ovarian cancer with multiple peritoneal metastases and a large amount of ascites.

II. Treatment Process#

  • Not suitable for surgery at the moment, chemotherapy was initiated first.
  • Carboplatin and paclitaxel-based chemotherapy for 5 cycles, each cycle lasting 21 days.
  • After chemotherapy, single-agent olaparib was taken orally twice a day for maintenance over 5 years.
  • During this period, CA125 was tested monthly, and enhanced CT scans were conducted every six months.

III. Treatment for Recurrence#

  • CT in April 2024 indicated recurrence, with abnormal elevation of CA125.
  • Continued with carboplatin, paclitaxel, and bevacizumab for 4 cycles of chemotherapy.
  • In the 5th cycle, there was an allergy to carboplatin, leading to a pause in carboplatin chemotherapy (this is a hidden danger).
  • In the 6th and 7th cycles, although carboplatin was replaced with cisplatin for continued chemotherapy, CA125 continued to rise.
  • Chemotherapy ended in August 2024, continued oral olaparib, but CA125 still kept rising.
  • On New Year's Day 2025, olaparib was stopped, and an attempt was made to maintain with oral letrozole.
  • In April 2025, an attempt was made to add niraparib for maintenance, with CA125 exceeding 1000.

IV. Current Dilemma#

  • General physical condition is average, RBC 3.0, HB 97, PLT 104.
  • Recently experienced irregular lower gastrointestinal bleeding, with a significant amount on May 24.
  • Economic condition is average; what treatment plan should be used next?
  • Is intraperitoneal hyperthermic perfusion therapy possible?
  • If hyperthermic perfusion is possible, will cisplatin be ineffective like in the 6th and 7th cycles of chemotherapy?
  • Seeking guidance from industry experts.
  • photo by A. C.(https://unsplash.com/@3tnik?utm_source=templater_proxy&utm_medium=referral&fit=crop&mask=corners) on Unsplash
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