SMARCA4-deficient dedifferentiated ovarian carcinoma with rapid progression during adjuvant platinum-based chemotherapy: a case report and implications for molecular-driven treatment strategies

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Authors

BEDNAŘÍKOVÁ Markéta HAUSNEROVÁ Jitka POKORNÁ Petra FELSINGER Michal RICHTER Svatopluk EHRLICHOVÁ Lucie ORLÍČKOVÁ Jana MINÁŘ Luboš SLABÝ Ondřej WEINBERGER Vít

Year of publication 2025
Type Article in Periodical
Magazine / Source THERAPEUTIC ADVANCES IN MEDICAL ONCOLOGY
MU Faculty or unit

Faculty of Medicine

Citation
web https://journals.sagepub.com/doi/10.1177/17588359251376858
Doi https://doi.org/10.1177/17588359251376858
Keywords case report; dedifferentiated ovarian carcinoma; personalized treatment; SLFN11; SMARCA4; SWI/SNF chromatin remodeling complex
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Description Dedifferentiated ovarian carcinomas (DDOC) are rare and aggressive malignancies characterized by a mixture of differentiated and undifferentiated tumor components, often associated with poor prognosis. This case report describes a 55-year-old woman initially diagnosed with early-stage high-grade endometrioid ovarian carcinoma who experienced rapid disease progression during adjuvant platinum-based chemotherapy, culminating in death within 4 months. Retrospective molecular analyses revealed pathogenic variants in the SMARCA4 gene, leading to a revised diagnosis of DDOC. The tumor exhibited resistance to conventional chemotherapy, highlighting the challenges associated with managing this aggressive tumor subtype. In our case, molecular profiling identified two potentially targetable alterations: biallelic SMARCA4 loss and a pathogenic PIK3CA mutation, both of which may inform future therapeutic strategies. This case underscores the importance of integrating molecular diagnostics into routine practice for accurate classification and highlights the urgent need for personalized treatment strategies, including targeted and immunotherapy options, for this formidable tumor subtype.
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