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Ongoing through the report (attachments removed to protect the patient's identity), the probable diagnosis is Stage III cancer (involving left parametrium, left adnexa, and left pelvic lymph nodes).
For women requiring first-line chemotherapy for EOC (epithelial ovarian cancer), the standard IV (intravenous) regimen utilizes Platinum and Taxane agents. We prefer Carboplatin rather than Cisplatin because multiple trials have consistently demonstrated that Carboplatin produces equivalent response rates and survival outcomes to Cisplatin but is associated with less toxicity.
Although both Paclitaxel and Docetaxel (the most commonly used taxanes for EOC) can be administered along with Carboplatin in this setting, we prefer Paclitaxel because it is less myelosuppressive than Docetaxel.
Dose-dense intravenous (IV) therapy refers to administering chemotherapy with less time between treatments, typically in ovarian cancer, which refers to a weekly schedule. It typically refers to one of two regimens:
1) Carboplatin is administered every three weeks, with Paclitaxel administered weekly.
2) Both Carboplatin and Paclitaxel are administered weekly.
Evaluation of women after adjuvant chemotherapy varies depending upon clinician preference. At the completion of treatment, we perform a history and physical (including pelvic) examination and cancer antigen (CA) 125. Imaging such as computed tomography (CT) of the chest, abdomen, and pelvis may be utilized as well, especially in those who do not have an informative biomarker (example: CA 125)
Homologous recombination deficiency (HRD) is being evaluated as a biomarker for the selection of patients for poly (ADP-ribose) polymerase (PARP) inhibitor maintenance after initial therapy,
Trials evaluating PARP inhibitor maintenance therapy have found greater benefits for those with HRD (homologous recombination deficient) tumors relative to nongenetically altered ovarian cancers and similar to those with BRCA (breast cancer gene) associated tumors. Olaparib plus Bevacizumab has regulatory approval by FDA (Food and drug administration) for the maintenance treatment of adult patients with deleterious or suspected deleterious germline or somatic BRCA-mutated advanced EOC who are in complete or partial response to first-line Platinum-based chemotherapy and whose cancer is associated with HRD-positive status defined by either a deleterious or suspected deleterious BRCA mutation and/or genomic instability.
I hope this was helpful.