Parps and Caelyx/Carbo???

[rossnbren]

Hope all you wonderful ladies are going as well as can be😊 A question??...I have been wondering why some ladies are prescribed a Parp Inhibitor and some Caelyx/ Carbo after a recurrence? Is it to do with the grade and type of OC? Or The time factor between finishing chemo and the recurrence?? and which would be the best option?? Have a happy day💐

[Lizchips]

I have stage 3c clear cell ovarian, diagnosed April 2014, no reoccurance, never prescribed either. Sorry don't have any idea. I'm sure others might know. Liz

[rossnbren in reply to Lizchips]

That’s great Liz.. may it continue xx

[LittleSan]

I'm really not sure, like you, I'd say that it depends on multiple factors such as an individuals genetic make-up, tolerance to response to previous treatment, general health and a bit of medical practitioners preference. So very much an individual clinical decision but it's my understanding that if recurrence is within 6 months of a platinum therapy then it's rarely used again because the cancer is regarded as resistant to platinum. Caelyx (or gemcitabine or Taxol) is generally a top up chemo to boost the efficacy of platinum but can work well as a solo chemo. PARPs are generally given as maintenance drugs here in the UK but they can shrink disease so can sometimes be used to treat too.

Hope this helps but there's no info as valuable as that from your team or perhaps the Ovacome helpline.

Warmest wishes to you. 💐

[Tesla_7US]

If after completing chemo the scan is not NED and patient has only partial response then patient may be directed immediately to a PARP. PARPS produce widely varying results in favor of patients BRCA positive. This is why it's so important to have original tumor tissue tested. I am BRCA germline (hereditary) negative, but my tumor tissue is BRCA1 positive and therefore somatic (acquired).

There must be something amiss with my hereditary DNA that allowed me to acquire mutations for BOTH breast cancer AND ovarian cancer.

[thomas62 in reply to Tesla_7US]

HI Tesla_7US

May I ask where you had your tissue checked out? Thanks. Gwen Xx

[Tesla_7US in reply to thomas62]

FoundationOne CDx

Foundation Medicine

PO Box 347790

Pittsburgh, Pennsylvania USA

15251-4790

Customer Service: [phone]

[thomas62 in reply to Tesla_7US]

Hi again Tesla_7US

Thanks very much for the name/address.

Best wishes. Gwen Xx

[Seasun36-uk]

I thought that PARPs were ‘maintainence’ therapy after destroying OC with chemo...

[rossnbren]

Thanks ladies.. all a bit confusing but get a general idea... xx🤗

[Maxjor]

When I finished Carbo/Caelyx, my ca 125 was 9 but I had very very small "seeding" as my onc called it but he said it was considered a "good response" and that a PARP would clean up the rest (fine with me to be done with the chemo!). In the first 3 months on the PARP, my ca125 went to 5 and I was considered NED. So I guess it can depend on a bunch of factors and I also think it is used as treatment but in higher doses than when maintenance--there are some clinical trials here in the US combining PARPs with immunotherapy drugs (Keytruda) and Avastin and they are finding much longer remissions are happening. They are trials though....don't know if and when they would go to market. I don't know if I helped but just some more info! oxox Judy

[bluepeterella]

I had my first recurrence in January after 15 months clear. My oncologist was very positive about all that could be done for me, put me on 6 sessions of Carbo/Caelyx with the intention of following up with a PARP inhibitor afterwards. The chemo as I understand it is to get rid of the cancer and the PARP is to keep it away for as long as possible. I don't think the PARP is designed to kill the fast-growing cells so wouldn't be prescribed on its own for a recurrence. I'm up to session 4 of chemo with a good response, CA125 now within normal levels, and I'm hoping the PARP once I start it will keep things from kicking off again.

[Tabor]

Hello rossnbren,

I had 2 tumors, one in each fallopian tube stage 2 and a stage 3 in other. Had surgery and complete rounds of chemo 2014. Cancer came back 2 different times and had complete rounds of chemo 2 more times, each with diff drugs. Dr put me on Rubraca to help keep it from coming back so soon. I am brac2 positive so I’m praying the Rubraca will keep it away. I’ve been on Rubraca since Sept 2018 feeling great, I get CA125 test once a month at its staying at 4.0 hope this info helps.

Praying all will be good for you!

[rossnbren]

Thats sounds like good news BluePeterella, I wish you well.. I had recurrence after 18months last Nov and am on watch and wait .. have small nodes along my arteries that are growing very slowly in fact one has shrunk and have one new one....my Oncol is very happy and so am I😊and like you we wait.

[Numi]

Hi. I'm on Niraparib. I had 6 carbo/caelyx when I recurred and was told I could have the PARP inhibitor only if the chemo was successful as it required being platinum sensitive, and also for the reurrence to have been more than 6 months after finishing frontline (I managed 7). I'm also BRCA2, so when the chemo reduced my tumour and brought my CA125 down to the same level as it had been after my first chemo, my oncologist fought to get it for me even before it was licensed (it also needs to be started within 12 weeks of chemo). So glad she did - my CA125 is stable at half what chemo brought it down to and has been for months, and I've been on Niraparib for 20 months. Hope that helps. All the best.

[rossnbren in reply to Numi]

That’s fantastic Numi and thanks for the info everyone...the more you delve into OC the more unpredictable the progress and treatment is... no onesize fits all that for sure. Xxx