Abstract YO17
Case summary
Serous ovarian cancer accounts for 80% of ovarian cancer, most of them being high grade and the expected survival for recurrent disease is less than 12 months. CDK4/6 inhibitor has shown promising benefit in ER-positive metastatic breast cancer. A phase II trial showed that investigating palbociclib in recurrent ovarian cancer has shown tolerable toxicity profile and radiological median PFS of 3.7 months and Gynecologic Cancer InterGroup CA125 criteria median PFS of 4.0 months. Therefore CDK4/6 inhibitors used alone or as combination could be useful in recurrent ovarian cancer. We report a case of recurrent ovarian cancer treated with palbociclib and letrozole.
Madam X was initially diagnosed with stage 3 ovarian cancer in 1994 at 25-years-old. She underwent TAHBSO, infracolic omentectomy followed by adjuvant carboplatin/paclitaxel. She was disease-free for 19 years until 2013 when she presented with pleural effusion which was confirmed to be recurrent papillary serous carcinoma. She received carboplatin/paclitaxel/bevacizumab combination for 8 months and stopped in view that the patient opted for a drug holiday. In 2016, her pleural effusion worsened. BRCA testing showed no BRCA1/2 mutation. She was then treated with carboplatin & pegylated liposomal doxorubicin for 6 cycles.
In April 2017, she presented with left axillary lymphadenopathy. Core biopsy showed high-grade serous carcinoma, positive for ER & PR; negative for HER2, PDL1 and MSI. She was then commenced on letrozole.
In May 2017, her CA15-3 was increasing from 55U/mL to 77U/mL, and letrozole was changed to tamoxifen. However, CA15-3 continued to rise to 113U/mL within a month. Her performance status was ECOG 0. She was then commenced on palbociclib 125mg OD 3 weeks on and 1 week off schedule with letrozole 2.5mg OD since June 2017. She tolerated palbociclib well and did not require any dose adjustments. The adverse events reported were grade 2 leucopenia and grade 2 neutropenia. CA 15-3 remained to respond for 14 months and she is still ongoing treatment.
In this case, palbociclib and letrozole have shown a prolonged PFS of more than 14 months and an excellent toxicity profile. This could present a potential therapeutic role of CDK4/6 inhibition in recurrent ovarian cancers.
Clinical trial identification
Editorial acknowledgement
Resources from the same session
143P - NOTCH3 expression predicts poor survival in advanced esophageal squamous cell cancers
Presenter: Raja Pramanik
Session: Poster display session
Resources:
Abstract
144P - Severe hypovitaminosis D in metastatic gastric cancer patients from the Northern and Southern hemispheres: Data from the EXPAND phase III trial
Presenter: Radka Obermannova
Session: Poster display session
Resources:
Abstract
145P - Role of Glasgow prognostic score in chemo-naïve patients with advanced biliary tract cancer and good performance status
Presenter: Toshikazu Moriwaki
Session: Poster display session
Resources:
Abstract
146P - Anatomic versus non-anatomic resection for hepatocellular carcinoma: A meta-analysis of high-quality studies
Presenter: Bin Zhang
Session: Poster display session
Resources:
Abstract
147P - Clinical outcomes of proximal gastrectomy versus total gastrectomy for locally advanced proximal gastric cancer: a propensity score matching analysis
Presenter: Yingtai Chen
Session: Poster display session
Resources:
Abstract
148P - Efficacy of capecitabine and oxaliplatin versus S-1 as adjuvant chemotherapy in gastric cancer after D2 lymph node dissection according to lymph node ratio and N stage
Presenter: Seunghwan Lee
Session: Poster display session
Resources:
Abstract
150P - A Phase Ib Study of IMU-131 HER2/neu peptide vaccine plus chemotherapy in patients with HER2/neu overexpressing metastatic or advanced adenocarcinoma of the stomach or gastroesophageal junction
Presenter: Yee Chao
Session: Poster display session
Resources:
Abstract
151P - Gene expression profiling for a better understanding of gastric cancer: From the perspective of metabolic rearrangement
Presenter: Midie Xu
Session: Poster display session
Resources:
Abstract
152P - Long-term outcomes of three-dimensional conformal radiotherapy-based and intensity-modulated radiotherapy-based concurrent chemoradiotherapy in patients with thoracic esophageal squamous cell carcinoma
Presenter: Chia-Lun Chang
Session: Poster display session
Resources:
Abstract
153P - Exosomal LINC00174 facilitates epithelial-mesenchymal transition in residual hepatocellular carcinoma after insufficient radiofrequency ablation by regulating c-JUN/MYCBP/c-Myc axis
Presenter: Dening Ma
Session: Poster display session
Resources:
Abstract