Low-grade epithelial ovarian cancer

Abstract

The results of phase III mitogen-activated protein kinase kinase inhibitor studies in low-grade serous ovarian cancer and further clinical and biological assessment of low-grade endometrioid and mucinous ovarian cancers are urgently required.

Binimetinib (MEK162) in recurrent low-grade serous ovarian cancer resistant to chemotherapy and hormonal treatment

“…Due to its unresponsiveness to cytotoxic chemotherapy, treatment of unresectable LGSOC has been a challenge. Alternative treatment modalities including hormonal therapy and anti-angiogenic agent have been studied ( Oswald and Gourley, 2015 ; Gershenson et al, 2009 ; Schmeler et al, 2008 ; Watanabe et al, 2016 ), however, treatment response to hormonal therapy is suboptimal (9%) and bevacizumab studies showed conflicting findings in terms of response-rate even though it did appear that anti-angiogenic treatment prolonged the duration of response ( Oswald and Gourley, 2015 ).…”

“…Low-grade-serous-ovarian-carcinoma(LGSOC) is a rare subtype of epithelial ovarian cancer (EOC) that accounts for 6–10% of serous ovarian cancer and 5–8% of all EOC ( Oswald and Gourley, 2015 ). Multiple studies demonstrated it is histologically, molecularly, and clinically distinct from high-grade-serous-ovarian-cancer (HGSOC) ( Oswald and Gourley, 2015 ; Vang et al, 2009 ).…”

“…Low-grade-serous-ovarian-carcinoma(LGSOC) is a rare subtype of epithelial ovarian cancer (EOC) that accounts for 6–10% of serous ovarian cancer and 5–8% of all EOC ( Oswald and Gourley, 2015 ). Multiple studies demonstrated it is histologically, molecularly, and clinically distinct from high-grade-serous-ovarian-cancer (HGSOC) ( Oswald and Gourley, 2015 ; Vang et al, 2009 ). LGSOC is typically diagnosed at a younger age compared to HGSOC, has an indolent growth rate and is resistant to cytotoxic chemotherapy compared to HGSOC; the response rate to cytotoxic chemotherapy in both the neoadjuvant and recurrent setting is <4% ( Gershenson et al, 2009 ; Schmeler et al, 2008 ).…”

Molecular classification of high grade endometrioid and clear cell ovarian cancer using TCGA gene expression signatures

“…Nevertheless these studies did suggest that clear cell and endometrioid ovarian cancers may be distinguished from serous ovarian cancers based on their gene expression profiles (6–10). However, many of these early studies included well differentiated tumors (G1) known to be distinct molecular entities (11). To date it is unclear if the evolving signatures which have been used to successfully classify HGSOC into four molecular subtypes could also be used to classify these less common epithelial ovarian cancer histologies.…”

“…All low grade tumors were excluded from this study as they are known to represent distinct biologic entities (11). We applied the pre-specified TCGA gene expression signatures and the reduced CLOVAR gene signatures to this cohort of 276 well annotated OCs from Mayo Clinic.…”