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- Title
Personally adapted one precision treatment for advanced ovary cancer patient.
- Authors
Min Kyu Kim
- Abstract
Best survival strategy for advanced ovary cancer treatment is surgical part and chemotherapy. Surgical debulking is composed of gynecologic and other area depending on surgeon's consultation, but without evident remnant image finding and detailed operation record, it's relatively subjective. Then, evidence based predictive test can be utilized objectively. We report one personally adapted precision treatment for advanced ovary cancer patient. A 69 years old Korean woman with pelvic ascites visited a Samsung Changwon Hospital. Her CA 125 was 10893. Staging operation was done with GS consultation. Surgery date: 2023 February. Staging op including hysterectomy was done with total proctocolectomy with end ileostomy. Pathology: BO (14/13 cm) SB mesentery, spleen, peritoneum, LN (+), right after operation during her recovery, precision test regarding predictive marker is done fully. Results: ER/PR/HER2/PD-L1(+/+/-/<1%) (MSS) NGS (Germline): SUFUBCNS, MDB, basal cell nevus syndrome, medulloblastoma. NGS (Somatic): TP53, MYC - Copy gain, MAPK1 - Copy gain (Wz4002)AURKA-Copy gain, FMO3--PDGFRA RET--PARP11. FoundationOne Liquid CDx: TP53 R2373C, DNMT3A E473fs*175, W306*Myriad HRD: 66 (No BRCA 1,2 somatic mutation). We recommend PAOLA 1 regimen for her. She agreed physician's choice. Her chemotherapy schedule was: 2023 March-July: Taxol-carboplatin #6 (CA 125:1049--91--23- 12-10-8) 2023 June-Present Avastin 15 mg/kg IV q 3weeks (#7) +2023 August-Present Lynparza 600 mg po (CA 125:7--6.7--7.0--7.2--7.2) AP CT (2023 November): CR. There is still uncertainty regarding her future recurrence. It's not easy to apply evidencebased precision medicine for all advanced ovary cancer patient due to available predictive test, insurance and cost. But it's even harder to prohibit one precious patient from approaching evidence treatment in the era of vast open information changing environment.
- Subjects
CANCER patients; RESTORATIVE proctocolectomy; BASAL cell nevus syndrome; PREDICTIVE tests; PHYSICIANS; SOMATIC mutation
- Publication
Journal of Gynecologic Oncology, 2024, Vol 35, p60
- ISSN
2005-0380
- Publication type
Article
- DOI
10.3802/jgo.2024.35.S2.P81