Complete pathological response to olaparib and bevacizumab in advanced cervical cancer following chemoradiation in a BRCA1 mutation carrier: a case report

J Med Case Rep. 2021 Apr 23;15(1):210. doi: 10.1186/s13256-021-02767-9.

Abstract

Background: Homologous recombination deficiency is a marker of response to poly(ADP-ribose) polymerase inhibitors in different cancer types including ovary, prostate, and pancreatic cancer. To date, no report about poly(ADP-ribose) polymerase inhibitors has been published on cervical cancer.

Case presentation: Here we present the case of a patient with cervical cancer treated in this setting. A 49-year-old woman diagnosed with International Federation of Obstetricians and Gynecologists stage 2018 IIIC2 locally advanced undifferentiated cervical cancer received first-line chemoradiotherapy followed by carboplatin, paclitaxel, and bevacizumab with partial response. Because of a family history of cancers, the patient was tested and found positive for a pathogenic BRCA1 germline and somatic mutation, which motivated bevacizumab plus olaparib maintenance treatment. A simple hysterectomy was performed after 2 years stable disease; pathological report showed complete pathological response, and 12 months follow-up showed no recurrence.

Conclusion: Poly(ADP-ribose) polymerase inhibitors could be an alternative maintenance treatment for patients with persistent advanced cervical cancer previously treated with platinum, especially when familial history of cancers is reported. Clinical trials using poly(ADP-ribose) polymerase inhibitors for advanced cervical cancer are warranted.

Keywords: Advanced cervical cancer; BRCA1; Olaparib; PARP inhibitor; Precision oncology.

Publication types

  • Case Reports

MeSH terms

  • BRCA1 Protein / genetics
  • Bevacizumab / therapeutic use
  • Chemoradiotherapy
  • Female
  • Humans
  • Middle Aged
  • Mutation
  • Neoplasm Recurrence, Local / drug therapy
  • Ovarian Neoplasms* / drug therapy
  • Phthalazines
  • Piperazines
  • Uterine Cervical Neoplasms* / drug therapy
  • Uterine Cervical Neoplasms* / genetics

Substances

  • BRCA1 Protein
  • BRCA1 protein, human
  • Phthalazines
  • Piperazines
  • Bevacizumab
  • olaparib