Temozolomide and olaparib for the treatment of an ARID1A-mutated uterine carcinosarcoma: A case report.

Authors

Chrissy Liu, Yasmin Abozenah, Thomas J Rutherford, Vaagn Andikyan, Adrian Kohut, Matthew L Anderson

Published in

Gynecologic oncology reports. Volume 67. Pages 102210. Epub Sep 08, 2026.

Abstract

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.
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.
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.

PMID:
42763538
Bibliographic data and abstract were imported from PubMed on 20 Sep 2026.

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