CA-125 rising on Olaparib

[msuspartan]

My mom had surgery/HIPEC in July 2020. Her latest CA125 result has come at 1500. She started 300 mg Olaparib/day 3 weeks back but not seeing any impact at this point. Onco started lower dose due to her blood numbers. Any suggestion on this situation. What else could be done. Bit worried for her..thanks

[RoseMS]

Hi. Can i please ask, when did the chemo actually end? My understanding is that PARP should start within 8 weeks of chemo ending. I am on 600mg a day Olaparib as normal dose since summer and tolerating well. I am 5’2” and 130lbs. Also wonder why she is on half dose. Its early days, 3 weeks and Ive found that the PARP takes a while to work but would be concerned with that CA figure. Best wishes to you and your mom.

[msuspartan in reply to RoseMS]

Hi There, thanks for your response. Her chemo ended in July 2020. Her post surgery CA125 was 290. Her latest PET scan done when her count was 900 a month back. Scan showed no active disease site. Doc is not recommending chemo as they are saying there is no active site. We are in a conundrum with her case as her CA125 is not having a great correlation. She is mostly staying asymptomatic. Just for history, her ascites showed up in first time around when her CA125 was over 100K. We are just puzzled..

[RoseMS in reply to msuspartan]

Yes it does sound puzzling. Do I read correctly: mums CA125 was over 100k at diagnosis and had ascites? Such a number makes her current level sound very low, maybe this is what is normal for her? (I was 5000 on diagnosis, with gross ascites, last check was 6). If there is nothing on the PET scan thats great. Please keep us posted and good luck.

[msuspartan in reply to RoseMS]

Yes, thats correct, to be more precise, it was close to 112K. Our concern now is a continuous rise in it. Scan will be repeated in 3 months so will see then..thanks and good luck..

[delia2]

Starting a PARP so many months after chemo is definitely outside the norm. Is your mother BRCA positive? If her blood counts are okay maybe they could increase the dose. I’m on 400 mg Olaparib a day and it got rid of my small nodule. Given that the PET showed nothing she may be in remission? Keep us posted.