Targeted treatment for an 89-year-old woman with Stage IV HRD-positive ovarian cancer

What happened, in summary

An 89-year-old woman was admitted in August 2024 after 4 months of lower abdominal pain, nausea, and vomiting. Imaging showed large masses involving both ovaries, fluid in the abdomen, and other concerning abdominal findings. Testing of abdominal fluid supported adenocarcinoma, and the overall workup confirmed high-grade serous ovarian cancer. The disease was Stage IV.

Genetic testing found a pathogenic germline BRCA2 variant and showed homologous recombination deficiency, or HRD positivity. Because of her age, general condition, and poor nutritional status, she was not considered able to tolerate surgery or conventional chemotherapy.

She instead started oral fluzoparib, a PARP-targeted treatment, together with megestrol acetate. Follow-up scans about every 3 months showed a partial response. Her tumor-marker levels moved toward normal, her appetite and general condition improved, and she did not require treatment interruption.

At the latest follow-up, she had remained on treatment for 7 months without progression and continued to show a meaningful clinical response.