Match each patient's clinical presentation and tumor molecular profile with the most appropriate targeted therapy or management strategy based on current gynecologic oncology guidelines.
- A 62-year-old woman with stage III high-grade serous ovarian carcinoma in remission after initial platinum-based chemotherapy; somatic tumor testing reveals a pathogenic BRCA1 mutation.Maintenance therapy with a poly (ADP-ribose) polymerase (PARP) inhibitor
- A 68-year-old woman with recurrent, metastatic endometrioid endometrial adenocarcinoma; tumor immunohistochemistry demonstrates loss of MLH1 and PMS2 expression.Monotherapy with an immune checkpoint inhibitor (PD-1 blocker)
- A 55-year-old woman with recurrent high-grade serous ovarian carcinoma that progressed during platinum-based chemotherapy; tumor profiling shows high expression of folate receptor-alpha.Therapy with a folate receptor alpha-directed antibody-drug conjugate
- A 45-year-old woman with metastatic squamous cell carcinoma of the cervix; tumor testing reveals a Programmed Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of 25.Combination systemic therapy including chemotherapy, an anti-VEGF agent, and a PD-1 blocker
Answer
Match the BRCA1-mutated ovarian cancer to PARP inhibitor maintenance, the dMMR endometrial cancer to PD-1 inhibitor monotherapy, the platinum-resistant FR-alpha positive ovarian cancer to an antibody-drug conjugate, and the PD-L1 positive metastatic cervical cancer to combination chemo-immunotherapy plus anti-VEGF.
Each specific gynecologic malignancy scenario relies on a unique biomarker (BRCA, dMMR, FR-alpha, PD-L1) that dictates its corresponding optimal targeted therapy according to the latest standards of care.
Step-by-Step Solution
Key Concept
Molecular profiling and targeted therapies in advanced gynecologic malignancies
Estimated Time:2m 0s