Stage III Ovarian Cancer in a BRCA1 Carrier Treated With Long-Term Maintenance Therapy

What happened, in summary

A 55-year-old woman underwent optimal debulking surgery for Stage III high-grade serous ovarian cancer. Genetic testing later showed a BRCA1 mutation. She received 6 cycles of carboplatin and paclitaxel and achieved a clinical complete response.

Within 5 months, her CA-125 level began rising again. She entered a clinical trial using topotecan with pegylated liposomal doxorubicin and completed 6 induction cycles. She then continued pegylated liposomal doxorubicin as maintenance therapy for about 11 years. During that long treatment period, she had no documented ovarian cancer recurrence.

In late 2008, she developed tongue pain and a white thickened area under the tongue. Biopsy showed dysplasia rather than invasive cancer, and the area was completely excised with skin grafting. Pegylated liposomal doxorubicin was stopped. At the latest follow-up, she had no further suspicious tongue lesions and no evidence of ovarian cancer. Her case reflects both prolonged ovarian cancer control and the challenges of very long-term treatment exposure.