Relapse Post radical debulking and first line chemo treatment

[RomanZ]

Hi all,

Apologies if this has been covered in previous posts, however, i couldn't find any information from what I've read thus far.

Is there a specific type of ovarian cancer cell that responds better to inhibitors?

From what I've read, most ovarian cancers are epithelial and I'm assuming most of the people on this forum discussing inhibitors all have the same type of cancer cell? Is there more detail to it and does it need to be confirmed through a genetic test?

Post first line treatment, if the cancer relapses after 8 months, should the person be undergoing the same carboplatin/paclitaxel treatment or is it time to consider inhibitors along with the chemo?

What i'm trying to understand is who is able to receive inhibitors and when should they consider them?

Also, it seems that most clinical trials are around inhibitors as opposed to new drugs that treat the cancer directly. Are there any recent success stories out there?

Thank you in advance.

Roman

[Numi]

Hi. I had a recurrence of high grade serous 7 months after frontline carbo/taxol and surgery. I then had carbo/caelyx, and as that worked, I qualified to get Niraparib (PARP-inhibitor) after that and I've been on it since October 2017. I was told at the time it would only be given if I was platinum sensitive, which thankfully I was, and that it would be particularly suitable for me as I have the BRCA2 gene mutation. I know since then, it's been given to women without the gene mutation.

[RomanZ in reply to Numi]

Numi, thank you so much for your reply.

What were your CA125 levels at the time of relapse?

[Neona]

I am on a clinical trial for an ATR inhibitor so I guess there are many different inhibitors out there. I think a lot depends on your type of cancer and specific mutations. It is quite difficult to understand so worth asking your oncologist and be prepared to get a second opinion if necessary.

[RomanZ in reply to Neona]

Hi Neona,

Thanks for your reply and hope treatment is going well. How are you feeling on the inhibitors you're receiving? Were you positive for a gene mutation.

Thanks

Roman

[Neona in reply to RomanZ]

I have be told that I have the P13k 31 mutation but wondering if I also have ARID1A sotrying to find out. The ATR inhibitor is pills that I take twice a day. I feel quite nauseated on them but nowhete near as bad as on frontline chemo- which didn’t work. My main problem had bern kidney damage from the frontline chemo.

[Maxjor]

Hi--I relapsed 7 months post frontline and told my onc myself I did not want the same treatment again because it only lasted 7 months. They did Carbo/Doxil (Caelyx) same as Numi. I then went on a PARP (also BRCA2 like Numi) and that lasted a year (still on it because it is keeping my recurrence slow growing). I believe Niraparib is approved for non BRCA but I also think all the PARPs want you to have platinum based chemo before you start (do NOT quote me---I think I could be wrong about that--good to ask your oncologist). I would get genetic testing if you can...there are treatments for both BRCA and non but some are specific to that information. You can always do another type of chemo or, as Numi is doing, some treatment that is not chemo. I also may be going to an ATR inhibitor next as a clinical trial as I want to avoid chemo as long as possible. Wishing you luck in your research and keep a list of questions for your next appt with your oncologist. Hugs and more, Judy

[RomanZ in reply to Maxjor]

Thank you Judy for your reply. It sounds like a good strategy to try to stay off chemo as long as possible and as long as the recurrence is slow.

How long were you in remission prior to the second relapse and how long has it been since you were diagnosed.

Good luck with the next trial. I hope it all goes well.

[Maxjor in reply to RomanZ]

Dx July 2016; adjuvant treatment--chemo/debulking (Nov 2016) Chemo. Recurred 7 months after finishing chemo (July 2017) then did a trial of immunotherapy (Obdivo) which did not work, then Carbo/Caelyx (finished March 2018) then PARP started April 2018 and numbers started to go up by 2s around December 2018 (tested every 4 weeks) until April 2019 when they doubled. Nothing being done yet--scan showed small amount of disease in April. Next scan May 29th. Then I think I go onto the next trial I hope to get into. oxox

[RomanZ]

Thanks for sharing Judy and all the best with your next trial.