The use of PARP inhibitors as maintenance therapy in ovarian carcinosarcoma: A case series

Objective

Carcinosarcoma an aggressive subtype of ovarian cancer. While treatment consists primarily of cytoreductive surgery followed by platinum-based chemotherapy, maintenance therapy can also be considered. Limited data exists on the use of poly ADP-ribose polymerase (PARP) inhibitors in ovarian carcinosarcoma, though this has been anecdotally successful among a small number of patients. In this case series, we present four patients with advanced or recurrent ovarian carcinosarcoma who were successfully treated with PARP inhibitors.

Methods

This case series included patients ages 18 or older who were diagnosed with ovarian carcinosarcoma and received maintenance therapy with a PARP inhibitor. Patient demographic and oncologic data was extracted. Cases were presented in detail and descriptive statistics were performed. A literature review was conducted to identify additional published case reports.

Results

Four patients from our institution were identified upon review of the electronic medical record. Age range at time of diagnosis was 47 to 74. Of the four patients, three (75 %) were treated in the upfront setting and one (25 %) was treated in the recurrent setting. Two patients were positive for homologous recombination deficiency, and another was positive for a CHEK2 mutation. Progression-free survival (PFS) while receiving treatment with a PARP inhibitor ranged from 13 to 72 months. One patient passed away 46 months after diagnosis, while three other patients remain alive from 25 to 108 months.

Conclusions

We present a series of patients with ovarian carcinosarcoma who were treated with PARP inhibitors at our institution and saw clinically meaningful benefits, both in the upfront and recurrent setting.