Trends of low-grade serous ovarian carcinoma in the United States

AbstractIn the early 2000s a two-tier grading system was introduced for serous ovarian cancer. Since then, we have increasingly come to accept that low-grade serous ovarian carcinoma (LGSOC) is a separate entity with a unique mutational landscape and clinical behaviour. As less than 10% of serous carcinomas of the ovary are low-grade, they are present in only a small number of patients in clinical trials for ovarian cancer. Therefore the current treatment of LGSOC is based on smaller trials, retrospective series, and subgroup analysis of large clinical trials on ovarian cancer. Surgery plays a major role in the treatment of patients with LGSOC. In the systemic treatment of LGSOC, hormonal treatment and targeted therapies seem to play an important role.

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Technologies for Detection of Babesia microti: Advances and Challenges

Pathogens ◽

10.3390/pathogens10121563 ◽

2021 ◽

Vol 10 (12) ◽

pp. 1563

Author(s):

Scott Meredith ◽

Miranda Oakley ◽

Sanjai Kumar

Keyword(s):

United States ◽

Early Stage ◽

Parasite Burden ◽

The United States ◽

Babesia Microti ◽

Current Status ◽

Low Grade ◽

Babesia Species ◽

Technological Advances ◽

Human Babesiosis

The biology of intraerythrocytic Babesia parasites presents unique challenges for the diagnosis of human babesiosis. Antibody-based assays are highly sensitive but fail to detect early stage Babesia infections prior to seroconversion (window period) and cannot distinguish between an active infection and a previously resolved infection. On the other hand, nucleic acid-based tests (NAT) may lack the sensitivity to detect window cases when parasite burden is below detection limits and asymptomatic low-grade infections. Recent technological advances have improved the sensitivity, specificity and high throughput of NAT and the antibody-based detection of Babesia. Some of these advances include genomics approaches for the identification of novel high-copy-number targets for NAT and immunodominant antigens for superior antigen and antibody-based assays for Babesia. Future advances would also rely on next generation sequencing and CRISPR technology to improve Babesia detection. This review article will discuss the historical perspective and current status of technologies for the detection of Babesia microti, the most common Babesia species causing human babesiosis in the United States, and their implications for early diagnosis of acute babesiosis, blood safety and surveillance studies to monitor areas of expansion and emergence and spread of Babesia species and their genetic variants in the United States and globally.

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XXIII.—The Development of Brief Narrative in Modern French Literature: A Statement of the Problem

PMLA ◽

10.1632/456940 ◽

1917 ◽

Vol 32 (4) ◽

pp. 583-597

Author(s):

Horatio E. Smith

Keyword(s):

United States ◽

Henry James ◽

French Literature ◽

English Language ◽

The United States ◽

Modern Literature ◽

Low Grade ◽

The World ◽

Bret Harte

Brief narrative, at first thought, connotes the abridged fiction of low grade with which American magazines are now saturated; but as soon as the term is used to cover the whole field in modern literature, it calls to mind a genre which, under various names, has risen to a position of dignity in many places in the world and has worthily engaged the attention of literary historians, particularly in America and in Germany.The chief features in the development of the form in the United States and England have been discussed at length, and there is now a definitive record, with abundant bibliographical apparatus, of its evolution. Poe is looked upon as the pioneer, and his perpetually quoted definition (1842) has set a standard for the majority of the practitioners of the art in the English language. The form suggests, for America, such experts as Hawthorne, Bret Harte, and Henry James; in England it does not gain the attention of writers of the first magnitude until near the end of the century, in the persons of Stevenson and Kipling.

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Therapeutic Approach to Low-Grade Serous Ovarian Carcinoma: State of Art and Perspectives of Clinical Research

Cancers ◽

10.3390/cancers12051336 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1336

Author(s):

Angiolo Gadducci ◽

Stefania Cosio

Keyword(s):

Ovarian Carcinoma ◽

Endocrine Therapy ◽

Biological Behavior ◽

Lower Sensitivity ◽

Low Grade ◽

Targeted Agents ◽

Mek Inhibitors ◽

Serous Ovarian Carcinoma ◽

Fertility Sparing ◽

Molecularly Targeted Agents

Low-grade serous ovarian carcinoma (LGSOC) is a distinct pathologic and clinical entity, characterized by less aggressive biological behavior, lower sensitivity to chemotherapy and longer survival compared with high-grade serous ovarian carcinoma. LGSOC often harbors activating mutations of genes involved in mitogen activated protein kinase (MAPK) pathway. Patients with disease confined to the gonad(s) should undergo bilateral salpingo-oophorectomy, total hysterectomy and comprehensive surgical staging, although fertility-sparing surgery can be considered in selected cases. Women with stage IA-IB disease should undergo observation alone after surgery, whereas observation, chemotherapy or endocrine therapy are all possible options for those with stage IC-IIA disease. Patients with advanced disease should undergo primary debulking surgery with the aim of removing all macroscopically detectable disease, whereas neoadjuvant chemotherapy followed by interval debuking surgery. After surgery, the patients can receive either carboplatin plus paclitaxel followed by endocrine therapy or endocrine therapy alone. Molecularly targeted agents, and especially MEK inhibitors and Cyclin-dependent kinase (CDK) inhibitors, are currently under evaluation. Additional research on the genomics of LGSOC and clinical trials on the combination of MEK inhibitors with hormonal agents, other molecularly targeted agents or metformin, are strongly warranted to improve the prognosis of patients with this malignancy.

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Low-grade serous ovarian carcinoma: an evolution toward targeted therapy

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2019-000832 ◽

2019 ◽

Vol 30 (10) ◽

pp. 1619-1626 ◽

Cited By ~ 3

Author(s):

Ioannis A Voutsadakis

Keyword(s):

Clinical Trials ◽

Targeted Therapy ◽

Ovarian Carcinoma ◽

Molecular Profile ◽

Low Grade ◽

High Grade ◽

Novel Therapies ◽

Precursor Lesions ◽

Molecular Defects ◽

Serous Ovarian Carcinoma

Low-grade serous ovarian carcinoma and its high-grade serous ovarian carcinoma counterpart differ in their precursor lesions, molecular profile, natural history, and response to therapies. As such, low-grade serous ovarian carcinoma needs to be studied separately from high-grade serous ovarian carcinoma, despite challenges stemming from its rarity. A deeper understanding of the pathogenesis of low-grade serous ovarian carcinoma and the most common molecular defects and pathways involved in the carcinogenesis of the ovarian epithelium from normal to serous borderline ovarian tumors to low-grade serous ovarian carcinoma will help develop better therapies. By adopting targeted approaches there may be an opportunity to integrate novel therapies without the need for robust numbers in clinical trials. This manuscript will discuss low-grade serous ovarian carcinoma and focus on the arising treatments being developed with an improved understanding of the pathogenesis of this disease.

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Use of adjuvant chemotherapy for early-stage low-grade serous ovarian carcinoma

Gynecologic Oncology ◽

10.1016/j.ygyno.2020.06.128 ◽

2020 ◽

Vol 159 ◽

pp. 61

Author(s):

J.K. Oh ◽

D. Nasioudis ◽

S. Gysler ◽

E.M. Ko ◽

M.A. Morgan ◽

...

Keyword(s):

Adjuvant Chemotherapy ◽

Ovarian Carcinoma ◽

Early Stage ◽

Low Grade ◽

Serous Ovarian Carcinoma

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Ultrasound, macroscopic and histological features of serous epithelial ovarian carcinomas

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2020-001473 ◽

2020 ◽

pp. ijgc-2020-001473

Author(s):

Paola Romeo ◽

Damiano Arciuolo ◽

Maria Cristina Moruzzi ◽

Francesca Moro

Keyword(s):

Ovarian Carcinoma ◽

Low Grade ◽

High Grade ◽

Ovarian Carcinomas ◽

Histological Features ◽

Serous Ovarian Carcinoma ◽

Epithelial Ovarian Carcinomas

We present a video showing two cases of serous epithelial ovarian carcinomas. The first video shows clinical, ultrasound, macroscopic, and histological features of a patient with high grade serous ovarian carcinoma. The second video presents clinical, ultrasound, macroscopic, and histological features of a patient with low grade serous ovarian carcinoma.

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