scholarly journals Case 1 – Stage IV low-grade serous ovarian carcinoma management in an elderly patient

2017 ◽  
Vol 5 (2) ◽  
pp. 39-45
Author(s):  
Luisa Sánchez-Lorenzo ◽  
Antonio González-Martín ◽  
David M. Gershenson
Keyword(s):  
Ovarian Cancer ◽  
Hormone Therapy ◽  
Histopathological Examination ◽  
Tumor Biology ◽  
Treatment Strategies ◽  
Progesterone Receptors ◽  
Stage Iv ◽  
Initial Assessment ◽  
Low Grade ◽  
Serous Ovarian Cancer

Recurrent low-grade serous ovarian cancer (LGSOC) is considered relatively chemoresistant; until more effective chemotherapy approaches become available, surgical management remains the mainstay of treatment. However, some subtypes of LGSOC behave distinctly differently from high-grade SOC. The upregulation of estrogen and progesterone receptors in ovarian cancer suggests hormone therapy as a possible treatment modality. Our patient was a 75-year-old woman with advanced low-grade papillary serous ovarian cancer. In consultation, supported by appropriate histopathological examination and immunohistochemical study to guide the treatment decisions, our Gynaecological Oncology Multi-Disciplinary Team recommended primary debulking surgery. The patient underwent surgery followed by hormone therapy with letrozole, after declining bevacizumab-containing adjuvant chemotherapy. Eighteen months of ongoing monitoring has shown no signs of progressive disease and stable tumor markers. This case highlights the importance of initial assessment by a multidisciplinary team experienced in gynecological oncology, together with knowledge of the tumor biology, to determine effective treatment strategies for the management of advanced LGSOC.

scholarly journals Evaluating Targeted Therapies in Ovarian Cancer Metabolism: Novel Role for PCSK9 and Second Generation mTOR Inhibitors

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3727
Author(s):  
Dafne Jacome Sanz ◽  
Juuli Raivola ◽  
Hanna Karvonen ◽  
Mariliina Arjama ◽  
Harlan Barker ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Lipid Metabolism ◽  
Cell Survival ◽  
Drug Testing ◽  
Cancer Metabolism ◽  
Ex Vivo ◽  
Specific Inhibitor ◽  
Low Grade ◽  
Serous Ovarian Cancer

Background: Dysregulated lipid metabolism is emerging as a hallmark in several malignancies, including ovarian cancer (OC). Specifically, metastatic OC is highly dependent on lipid-rich omentum. We aimed to investigate the therapeutic value of targeting lipid metabolism in OC. For this purpose, we studied the role of PCSK9, a cholesterol-regulating enzyme, in OC cell survival and its downstream signaling. We also investigated the cytotoxic efficacy of a small library of metabolic (n = 11) and mTOR (n = 10) inhibitors using OC cell lines (n = 8) and ex vivo patient-derived cell cultures (PDCs, n = 5) to identify clinically suitable drug vulnerabilities. Targeting PCSK9 expression with siRNA or PCSK9 specific inhibitor (PF-06446846) impaired OC cell survival. In addition, overexpression of PCSK9 induced robust AKT phosphorylation along with increased expression of ERK1/2 and MEK1/2, suggesting a pro-survival role of PCSK9 in OC cells. Moreover, our drug testing revealed marked differences in cytotoxic responses to drugs targeting metabolic pathways of high-grade serous ovarian cancer (HGSOC) and low-grade serous ovarian cancer (LGSOC) PDCs. Our results show that targeting PCSK9 expression could impair OC cell survival, which warrants further investigation to address the dependency of this cancer on lipogenesis and omental metastasis. Moreover, the differences in metabolic gene expression and drug responses of OC PDCs indicate the existence of a metabolic heterogeneity within OC subtypes, which should be further explored for therapeutic improvements.

Cost-effectiveness of maintenance hormonal therapy in patients with advanced low grade serous ovarian cancer

2021 ◽  
Vol 160 (1) ◽  
pp. 206-213
Author(s):  
Andra Nica ◽  
Ji Young Jennifer Lee ◽  
Nicole Look Hong ◽  
Taymaa May
Keyword(s):  
Ovarian Cancer ◽  
Cost Effectiveness ◽  
Hormonal Therapy ◽  
Low Grade ◽  
Serous Ovarian Cancer

scholarly journals Increase in post-therapy tumor calcification on CT scan is not an indicator of response to therapy in low-grade serous ovarian cancer

2016 ◽  
Vol 41 (8) ◽  
pp. 1589-1595 ◽  
Author(s):  
Dhakshinamoorthy Ganeshan ◽  
Priya Bhosale ◽  
Wei Wei ◽  
Preetha Ramalingam ◽  
Eniola Mudasiru-Dawodu ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Ct Scan ◽  
Response To Therapy ◽  
Low Grade ◽  
Serous Ovarian Cancer ◽  
Post Therapy

scholarly journals BRAF Mutation is associated with early stage disease and improved outcome in patients with low-grade serous ovarian cancer

Cancer ◽  
2012 ◽  
Vol 119 (3) ◽  
pp. 548-554 ◽  
Author(s):  
Rachel N. Grisham ◽  
Gopa Iyer ◽  
Karuna Garg ◽  
Deborah DeLair ◽  
David M. Hyman ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Braf Mutation ◽  
Early Stage ◽  
Low Grade ◽  
Serous Ovarian Cancer ◽  
Early Stage Disease ◽  
Stage Disease ◽  
Improved Outcome

Low-grade serous ovarian cancer: State of the science

2020 ◽  
Vol 156 (3) ◽  
pp. 715-725 ◽  
Author(s):  
Brian Slomovitz ◽  
Charlie Gourley ◽  
Mark S. Carey ◽  
Anais Malpica ◽  
Ie-Ming Shih ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Low Grade ◽  
Serous Ovarian Cancer ◽  
State Of The Science

scholarly journals Heterotypic CAF-tumor spheroids promote early peritoneal metastasis of ovarian cancer

2019 ◽  
Vol 216 (3) ◽  
pp. 688-703 ◽  
Author(s):  
Qinglei Gao ◽  
Zongyuan Yang ◽  
Sen Xu ◽  
Xiaoting Li ◽  
Xin Yang ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Peritoneal Dissemination ◽  
Tumor Stroma ◽  
Stromal Fibroblast ◽  
Low Grade ◽  
Cancer Associated Fibroblasts ◽  
Serous Ovarian Cancer ◽  
Active Involvement ◽  
Essential Components ◽  
Metastatic Capacity

High-grade serous ovarian cancer (HGSOC) is hallmarked by early onset of peritoneal dissemination, which distinguishes it from low-grade serous ovarian cancer (LGSOC). Here, we describe the aggressive nature of HGSOC ascitic tumor cells (ATCs) characterized by integrin α5high (ITGA5high) ATCs, which are prone to forming heterotypic spheroids with fibroblasts. We term these aggregates as metastatic units (MUs) in HGSOC for their advantageous metastatic capacity and active involvement in early peritoneal dissemination. Intriguingly, fibroblasts inside MUs support ATC survival and guide their peritoneal invasion before becoming essential components of the tumor stroma in newly formed metastases. Cancer-associated fibroblasts (CAFs) recruit ITGA5high ATCs to form MUs, which further sustain ATC ITGA5 expression by EGF secretion. Notably, LGSOC is largely devoid of CAFs and the resultant MUs, which might explain its metastatic delay. These findings identify a specialized MU architecture that amplifies the tumor–stroma interaction and promotes transcoelomic metastasis in HGSOC, providing the basis for stromal fibroblast-oriented interventions in hampering OC peritoneal propagation.

Paradigm Shift in the Management Strategy for Epithelial Ovarian Cancer

2016 ◽  
pp. e247-e257 ◽  
Author(s):  
Keiichi Fujiwara ◽  
Jessica N. McAlpine ◽  
Stephanie Lheureux ◽  
Noriomi Matsumura ◽  
Amit M. Oza
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Paradigm Shift ◽  
Management Strategy ◽  
Clear Cell ◽  
Treatment Strategies ◽  
Low Grade ◽  
Ovarian Carcinomas ◽  
Coelomic Epithelium ◽  
Histologic Types

The hypothesis on the pathogenesis of epithelial ovarian cancer continues to evolve. Although epithelial ovarian cancer had been assumed to arise from the coelomic epithelium of the ovarian surface, it is now becoming clearer that the majority of serous carcinomas arise from epithelium of the distal fallopian tube, whereas clear cell and endometrioid cancers arise from endometriosis. Molecular and genomic characteristics of epithelial ovarian cancer have been extensively investigated. Our understanding of pathogenesis of the various histologic types of ovarian cancer have begun to inform changes to the strategies for management of epithelial ovarian cancer, which represent a paradigm shift not only for treatment but also for prevention, which previously had not been considered achievable. In this article, we will discuss novel attempts at the prevention of high-grade serous ovarian cancer and treatment strategies for two distinct entities in epithelial ovarian cancer: low-grade serous and clear cell ovarian carcinomas, which are relatively rare and resistant to conventional chemotherapy.

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