PURPOSE OF REVIEW: The purpose of this study is to summarize the contemporary understanding of low-grade epithelial ovarian cancers. RECENT FINDINGS: Low-grade serous ovarian cancer is biologically distinct from high-grade serous ovarian cancer. It is associated with a high incidence of K-RAS and B-RAF mutations. Although described as indolent due to median progression-free and overall survivals of 20 and 99 months, respectively, with a median age of diagnosis of 43 years, it accounts for a significant number of patient-years lost. Retrospective studies suggest response rates of 5% for chemotherapy and 9% for antioestrogen therapy. A prospective study of the mitogen-activated protein kinase kinase inhibitor selumetinib (response rate 15%) and retrospective bevacizumab studies suggest that these may be more effective approaches.Limited retrospective clinical data and even more sparse molecular data suggest that similar distinctions may exist between low-grade endometrioid and mucinous ovarian cancers and their respective high-grade counterparts, but more research is required in order to clarify the biological differences and the implications that these have for management. SUMMARY: 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.
PURPOSE OF REVIEW: The purpose of this study is to summarize the contemporary understanding of low-grade epithelial ovarian cancers. RECENT FINDINGS: Low-grade serous ovarian cancer is biologically distinct from high-grade serous ovarian cancer. It is associated with a high incidence of K-RAS and B-RAF mutations. Although described as indolent due to median progression-free and overall survivals of 20 and 99 months, respectively, with a median age of diagnosis of 43 years, it accounts for a significant number of patient-years lost. Retrospective studies suggest response rates of 5% for chemotherapy and 9% for antioestrogen therapy. A prospective study of the mitogen-activated protein kinase kinase inhibitor selumetinib (response rate 15%) and retrospective bevacizumab studies suggest that these may be more effective approaches.Limited retrospective clinical data and even more sparse molecular data suggest that similar distinctions may exist between low-grade endometrioid and mucinous ovarian cancers and their respective high-grade counterparts, but more research is required in order to clarify the biological differences and the implications that these have for management. SUMMARY: 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.
Authors: Boris Winterhoff; Habib Hamidi; Chen Wang; Kimberly R Kalli; Brooke L Fridley; Judy Dering; Hsiao-Wang Chen; William A Cliby; He-Jing Wang; Sean Dowdy; Bobbie S Gostout; Gary L Keeney; Ellen L Goode; Gottfried E Konecny Journal: Gynecol Oncol Date: 2016-04 Impact factor: 5.482
Authors: Ellen L Goode; Matthew S Block; Kimberly R Kalli; Robert A Vierkant; Wenqian Chen; Zachary C Fogarty; Aleksandra Gentry-Maharaj; Aleksandra Tołoczko; Alexander Hein; Aliecia L Bouligny; Allan Jensen; Ana Osorio; Andreas Hartkopf; Andy Ryan; Anita Chudecka-Głaz; Anthony M Magliocco; Arndt Hartmann; Audrey Y Jung; Bo Gao; Brenda Y Hernandez; Brooke L Fridley; Bryan M McCauley; Catherine J Kennedy; Chen Wang; Chloe Karpinskyj; Christiani B de Sousa; Daniel G Tiezzi; David L Wachter; Esther Herpel; Florin Andrei Taran; Francesmary Modugno; Gregg Nelson; Jan Lubiński; Janusz Menkiszak; Jennifer Alsop; Jenny Lester; Jesús García-Donas; Jill Nation; José Palacios; Joseph H Rothstein; Joseph L Kelley; Jurandyr M de Andrade; Luis Robles-Díaz; Maria P Intermaggio; Martin Widschwendter; Matthias W Beckmann; Matthias Ruebner; Mercedes Jimenez-Linan; Naveena Singh; Oleg Oszurek; Paul R Harnett; Peter F Rambau; Peter Sinn; Philipp Wagner; Prafull Ghatage; Raghwa Sharma; Robert P Edwards; Roberta B Ness; Sandra Orsulic; Sara Y Brucker; Sharon E Johnatty; Teri A Longacre; Eilber Ursula; Valerie McGuire; Weiva Sieh; Yanina Natanzon; Zheng Li; Alice S Whittemore; deFazio Anna; Annette Staebler; Beth Y Karlan; Blake Gilks; David D Bowtell; Estrid Høgdall; Francisco J Candido dos Reis; Helen Steed; Ian G Campbell; Jacek Gronwald; Javier Benítez; Jennifer M Koziak; Jenny Chang-Claude; Kirsten B Moysich; Linda E Kelemen; Linda S Cook; Marc T Goodman; María José García; Peter A Fasching; Stefan Kommoss; Suha Deen; Susanne K Kjaer; Usha Menon; James D Brenton; Paul DP Pharoah; Georgia Chenevix-Trench; David G Huntsman; Stacey J Winham; Martin Köbel; Susan J Ramus Journal: JAMA Oncol Date: 2017-12-01 Impact factor: 33.006