Mother diagnosed with HG Ovarian cancer. Current Chemo not fully responding (reocurrence). Need suggestions/Guidance - Alternate treatments

[akhilsalwan]

My Mother was diagnosed with Ovarian Cancer (high grade Serous Carcinoma) in January 2022. Started Chemo in Feb, 2022(medicine used- Inj Paclitaxel (80 mg/ m2) (D1, D8 q 21 days) + Inj Carboplatin (AUC 5)(D1q3) and by April 2022 CA 125 was 9.

Got a Full Hysterectomy surgery and received Hipec chemotherapy.

Chemotherapy continued till August 2022. Received Maintenance treatment till December 2022 (9 doses of Avastin till Feb 2023)

Reoccurrence in January 2023, Rising CA-125, Biopsy from Peritoneal Deposits 20/3/2023 – Metastatic Adenocarcinoma. Chemo re-started received PLD + Bevacizumab till 03/05/2023. No improvement, CA125 rose from 44 to 85. Changed treatment to (Gemcitabine ( 1gm/m2)D1, D8 and Carboplatin AUC-5 -(150 mg). CA125 to 45.4 in Aug 2023.

Aug to September – took break from Chemo and in September started with Oral Chemo Pazopanib (600)+Endoxin(100)+Letrozol (2.5). CT scan (17.08.23) showed disease progression with little to no side effects/pain. Increase in stomach and back pain and stomach infection on 5.12.23. Took Antibiotics and infection medication for 7 days. CA125 increased from 215 (5.12.23) to 269 on (15.12.23). Latest petscan 18.12.23 showed further increase in disease. Last CA125 report increased to 338 (22.12.23).

Latest plan - Chemo restarted 12.29.23 Paclitaxel (60 mg/m2) weekly. Her Pains are increasing especially in her back.

Any suggestions on any alternative treatments while being on Chemo or after chemo?

Thoughts on Hope4Cancer in Mexico or Oasis of Hope in AZ? Are there any successful cases of OC there?

Few tests done

NGS

Brca and HRD test

ER + ,Pr + ,P16, P53 null

Biopsy

[Trickysite]

I am sorry to hear that your mother is having these difficulties. I gather you are based in India. I don't know anything about the health system there but I would urge you to seek a second opinion from a cancer specialist hospital as it is true that advice and treatment can vary and a specialist in ovarian cancer from a cancer centre of excellence hospital often makes a real difference. I have not heard of the alternative treatment centres you have cited but if you are contemplating travelling abroad for help, I would try the UK Royal Marsden's Christina Fotoupolou (sp?) or Professor Jayson at Manchester. These are experts in conventional therapy, not alternative. My best wishes, Emma

[akhilsalwan in reply to Trickysite]

Thank you for your suggestions, will surely take a look. Are they specific to Ovarian Cancer or cancer in general?

[Trickysite in reply to akhilsalwan]

Christina at the Royal Marsden and Prof. Jayson at Christies Hospital, Manchester are at the forefront as specialists in the treatment of Ovarian cancer. The NHS in UK has approved Olaparib as a two year maintenance course after first line of chemo treatment for Ovarian cancer (especially effective in BRCA positive patients). It has to be started within 8 weeks of final first line chemo. The NHS has also approved Olaparib as a continuous treatment in some cases of recurrence. It is a capsule. It targets just the cancerous cells, as opposed to chemo which attacks cells more generally. That is my understanding. Best wishes, Emma

[FDMD]

Hi there First off I want to send many blessings to you and your mother for a prosperous and promising new year ✨️ I had a question is your mom brca positive? I have had Ovarian cancer hgsc brca positive since 2018. And my few reaccurances have mainly been treated with surgery and chemotherapy .I heard about a drug called Elahere..not tried it but it is fairly new for oc patients who are now platinum resistant..also ask your Dr about immunotherapy options..sending lots of blessings your way.

[delia2]

That’s unusual to have P53 negative with high grade. Is it possibly a different subtype that is less responsive to chemo? My cancer responded only partially to second chemo but Olaparib took care of it. However I am somatic BRCA+. Is Elahere available in India?

[akhilsalwan in reply to delia2]

Hi what is Olaparib?

[Leniko]

have you considered MD Anderson for a consultation?

[akhilsalwan in reply to Leniko]

I have not, any specific doctor there you suggest for Ovarian cancer? What about Sloan Kettering?

[Leniko in reply to akhilsalwan]

MSKCC has quite a few excellent OVCA oncologists. I see Jason Konner but He’s at their NJ location (Monmouth).

I am keeping Anderson in my back pocket in case we want a second opinion at this junction in my recurrent cancer.

Wishing you the best!!!

[delia2]

Olaparib is Lynparza, a PARP inhibitor.

[akhilsalwan in reply to delia2]

Hi, Did you take Olaparib with IV chemo or after the chemo sessions were over?

[delia2]

After chemo but the chemo was only partially successful and the Olaparib got rid of the remaining cancer in six months.

[delia2]

Dr Shannon West is a specialist in OC at MD Anderson. They might do a virtual consult, not sure .

[akhilsalwan in reply to delia2]

I will research and see if I can get an appointment. What stage of OC did you have?

Is Elahere and Olaparib the same thing?