How do you manage a patient with BRCA1 mutation with stage IVA high grade serous ovarian carcinoma following complete cytoreduction and adjuvant chemotherapy, currently on PARP inhibitor maintenance, found to have residual suprafascial disease on pathology following ostomy reversal?

This is a situation much like an elevated Ca125 where the patient is 1) asymptomatic and 2) has NED on imaging but has disease present. The decision to stop the PARP inhibitor and start traditional chemotherapy would have to be a risk/benefit decision with the patient. The evidence of disease at the...