Low grade ovarian cancer – clinical and molecular aspects

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Published: 12 Jul 2018
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Dr Douglas Levine - NYU Langone Medical Center, New York, USA

Dr Levine speaks with ecancer at BCGS 2018 about low-grade serous carcinoma of the ovaries.

He highlights KRAS and BRAF mutations as markers of the disease, and targets for precision therapies.

Dr Levine also spoke with ecancer about immuno-oncology in SCCO, here.

This afternoon I’ll be talking about a low grade serous carcinoma of the ovary. This is a relatively uncommon type of ovarian cancer but certainly there are thousands of cases around the world. It’s very different than the most common type of ovarian cancer which is called high grade serous ovarian cancer. Low grade serous ovarian cancer is characterised by mutations in genes like KRAS and BRAF whereas high grade serous carcinoma has frequent, if not universal, mutations in TP53 which is not seen in low grade serous carcinoma. So the molecular genetics are very different and we can use that in making sure we’re making the correct diagnosis in cases where it can be tricky. It also could be used for therapeutic intervention in the future.

There is some evidence that BRAF mutations that can be targeted with BRAF inhibitors such as in melanoma and other cancers, there are some reports, although not overly common, but there are some reports of that working in low grade serous carcinoma. I’ll also be talking about other therapies that have been effective including anti-angiogenesis therapy with bevacizumab. Now there’s also some good data to suggest that a hormonal treatment can actually prevent the cancer from recurring.

What is your take home message?

The two take home messages would be that we can use genetics, both to correctly diagnose the cancer and also to open up therapeutic options. We have a lot of new therapeutic options for low grade serous carcinoma that did not exist ten years ago.