Mother with PPC stage IV

[KAIM83]

Hello everyone

Question from a worried son with a mother diagnoses with ppc stage 4 due to BRCA2 . She has completed chemo and surgery with good results. She first underwent 3 chemos, then surgery and 3 more chemocures. No visible cancer or cancercells in the omentum after sugery and the lastest CA-125 was 7.

After the last of 6 chemocures the 27th of november, she started up with Avastin/Bevacizumab. Last week she had to end the Avastin treatment due to high protein leves in her urine, so as of now she is not receiving any treatment.

A few weeks ago we learned about Lynparza/Olabarib, and the drug is currently in the approvement process here in Norway for my mothers diagnose. We have talked to several specialists and have received about just as many different advises. One advices us to delay the use of Olabarib until recurrence, one tells us Olabarib only works if you start it up no later than 10-12 weeks after last chemo. The third one is an independent private practitioner, and his advise is to start Olabarib right away. And the reason is her BRCA2 mutation and the effects of Olabarib in BRACA2 patients.

So, there we are. My mother is doing really well and she is back to her old self, working and worrying about us kids We, on the other side, are very avare of the probability of recurrence, and want to make sure she get´s the best treatment possible at her stage.

I´m hoping maybe anyone of you wonderfull people in here might be able to give us some good advice regarding the use of Lynparza/Olaparib at this stage. My worry is that without any treatment, the cancer will return quicker, but on the other side I´m worried about "using up" Lynparza now if the cancer will recure anyhow.

Thank you for reading my post. Any advice or reply is very appreciated.

Kind Regards

Kai

[Katmal-UK]

Hi Kai I 'm sorry to hear about your mother but glad to hear she is doing well. I am on a trial for Olaparib and been for 5years 3 months. From what I have learn the optimum time to start is within 8 weeks of completing Chemo. Might be worth looking up trials ? If u have any questions please let me know Best wishes Kathy xx

[Lindaura]

Dear friend,

I have not been offered Olaparub myself, although I am BRCA1 positive, but after successful first line treatment: Chemo/surgery/Chemo, with a CA-125 of 10, and feeling fantastic, 6 months later, I recurred.

I am now finishing second line treatment of Carbo/:Caelyx and am now eligible for Niraparib, a similar PARP inhibitor approved in the UK.

I will start this in May.

Meanwhile, I know that Olaparib is now approved after First Line in the USA.

I have included three interesting articles about the PARP Inhibitors here, and my advice is to read these and for your Mom to know that they are not without side effects, but most of us know how to manage nausea and digestive issues by now and the bone marrow suppression has to be managed by her medical team.

Best wishes,

Laura

ecancer.org/news/15240-olap...

This too:

ascopost.com/issues/decembe...

And this:

onclive.com/conference-cove...

[Lyndy]

Hello I was diagnosed stage 4 in 2015 and had Avastin. I am BRCA I. So far no recurrence but I am wary about taking treatment when you don’t necessarily need it. I had a scare last year but it came to nothing (but could have been put on chemo!) Now my doctor says wait for symptoms- then we will treat you.

In your Mums position- who is to say that she will recur or that it will be soon?

I would hold fire on any treatment until she needs it. Luckily BRCA carriers tend to respond really well to platinum chemo so if she does have to have it again then she could do the parp inhibitor afterwards xx

[Nstober]

Hi kai your mom is so lucky to have you. My sister went through the same protocol as your mom, NED now for 10 months, just off of Avastin after 4 rounds of maintenance chemo due to side effects and will go on a parp soon. She is a 4a and brca negative. Here in the states it seems to be the overall plan even when there is no sign of disease.

I wish you and your mom and family much good health and joy.

Nancy

[Rlenesue]

I would get started on the olaparib as she is braca1.