More decisions - Avastin, Niraparib or Letrozole

[Vinney52]

My Mum, who has done 6 rounds of chemo, 2 with Avastin, has just been told she still doesn't present as suitable for surgery. We have mixed emotions about this as she is in her early 80s, although previously very fit and healthy. She has been given 3 options to try to keep things at bay before possibly more chemo further down the line. (She was diagnosed stage 4a HGSOC in Sept 22).

I'm not sure why she seems to have to decide herself what is the right path to take as surely this is down to the specialists to advise. Hence my post here to see if others have been in this situation and to see if anyone has any opinions on these choices;

1. More Avastin over coming 3 months

2. Niraparib

3. Letrozole (not heard of this option in relation to OC)

Very grateful for any thoughts to help me pass on to my elderly parents who are pretty over-whelmed by all this.

Thank you!

[Trickysite]

I agree it seems crackers to ask the patient to choose! If they can’t give a reason why one med might be better than another, I would ask for a second opinion. Best wishes, Emma x

[Newbery3]

Hi 👋, I'm stage 4b and wasn't going to get surgery but went private for 2nd opinion and had surgery at the imperial hammersmith with Prof Christina. Anyway after surgery I told the Prof that the oncologist had offered me either avastin now or niraparib and keep avastin for reoccurrence? I asked for her advice as I too had no idea what to do! She told me BOTH! To attack to beast hard straight away.. I'm 52 now and hrd positive brca negative and live in Wales. I hope this helps 🙏 maybe get a 2nd opinion if your mum is fit xx

[Vinney52 in reply to Newbery3]

Very interesting - and helpful. Thank you! x

(so pleased you got your op)

[delia2]

I think Niraparib would be the most effective choice but at a reduced dose most likely. Letrozole has been shown to be effective for low grade OC. But I agree that the doctor should be guiding the choice.