Gynecologic oncology reports · 2026
Temozolomide and olaparib for the treatment of an ARID1A-mutated uterine carcinosarcoma: A case report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Liu Chrissy, Abozenah Yasmin, Rutherford Thomas J, Andikyan Vaagn, Kohut Adrian, Anderson Matthew L
Аннотация
BACKGROUND: Pathogenic ARID1A mutations are common in uterine carcinosarcoma (UCS) and may confer vulnerability to the combination of temozolomide (TMZ) and a poly (ADP-ribose) polymerase inhibitor (PARPi) through synthetic lethality. Clinical experience with this regimen in gynecologic cancers is limited and has not been reported in UCS.
CASE: A 54-year-old woman with stage IIIB UCS harboring a pathogenic ARID1A mutation developed isolated cavitating pulmonary metastases shortly after completing chemoradiation, surgery, and adjuvant carboplatin/paclitaxel with dostarlimab. She received off-label temozolomide and olaparib on a 21-day cycle. After four cycles, she achieved a complete radiographic response and has remained in clinical remission with normal CA-125 and negative circulating tumor DNA. Treatment was complicated by reversible grade 3-4 thrombocytopenia.
CONCLUSION: This case suggests that TMZ/PARPi may produce durable responses in biomarker-selected UCS and supports prospective evaluation of this regimen in genomically characterized, ARID1A-defined gynecologic cancers.
CASE: A 54-year-old woman with stage IIIB UCS harboring a pathogenic ARID1A mutation developed isolated cavitating pulmonary metastases shortly after completing chemoradiation, surgery, and adjuvant carboplatin/paclitaxel with dostarlimab. She received off-label temozolomide and olaparib on a 21-day cycle. After four cycles, she achieved a complete radiographic response and has remained in clinical remission with normal CA-125 and negative circulating tumor DNA. Treatment was complicated by reversible grade 3-4 thrombocytopenia.
CONCLUSION: This case suggests that TMZ/PARPi may produce durable responses in biomarker-selected UCS and supports prospective evaluation of this regimen in genomically characterized, ARID1A-defined gynecologic cancers.