Hormone maintenance therapy for women with low-grade serous ovarian cancer in the front-line setting: A systematic review

Lazurko, Caitlin; Clark, Mitchell; Pulman, Kate; Lennox, Genevieve K.; May, Taymaa; Fazelzad, Rouhi; Gien, Lilian T.; Zigras, Tiffany

doi:10.1016/j.ygyno.2021.07.027

Cited by 2 publications

(4 citation statements)

References 21 publications

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“…In addition to trials investigating the use of MEKi in the treatment of LGSC, trials are also underway investigating the efficacy of other agents, which include chemotherapy, as well as hormonal treatment. A previous systematic review on the role of hormonal maintenance therapy for women with LGSC demonstrated inconsistent results on efficacy, necessitating further research in this area 22 . Bevacizumab has also been shown to have activity against LGSC 5,10,11 .…”

Section: Discussionmentioning

confidence: 99%

“…A previous systematic review on the role of hormonal maintenance therapy for women with LGSC demonstrated inconsistent results on efficacy, necessitating further research in this area. 22 Bevacizumab has also been shown to have activity against LGSC. 5,10,11 Because no gold standard has yet to be identified in the treatment of LGSC, further research is needed on various systemic agents.…”

Section: Implications For Practice and Future Researchmentioning

confidence: 99%

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Treatment of Recurrent Low-grade Serous Ovarian Cancer With MEK Inhibitors

Kulkarni,

Cooke,

Fazelzad

et al. 2023

American Journal of Clinical Oncology

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Objective: Low-grade serous ovarian cancer (LGSC) represents 5% of all epithelial ovarian cancers. They are characterized by indolent growth and KRAS and BRAF mutations, differing from high-grade serous ovarian cancer both clinically and molecularly. LGSC has low response rates to traditional systemic therapies, including chemotherapy and hormonal therapy. The objective of this systematic review was to appraise the literature describing the efficacy of MEK inhibitors in the treatment of LGSC. Methods: A comprehensive search was conducted of the following databases: Medline ALL, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Web of Sciences, ClinicalTrials.gov, International Clinical Trials Registry Platform (ICFRP), and International Standard Randomized Controlled Trials Number (ISRCTN) Registry. All studies investigating MEKi in the treatment of LGSC in the adjuvant or recurrent setting for patients 18 years of age or older were included. All titles/abstracts were then screened by 2 independent reviewers (A.K. and C.C.). The full-text articles were then screened. All disagreements were resolved by a third independent reviewer (T.Z.). Two independent reviewers (A.K. and C.C.) extracted data from the studies deemed eligible for final review. Results: A total of 2108 studies were identified in the initial search. Of these, a total of 4 studies met the eligibility criteria for systematic review. In these studies, 416 patients were treated with an MEKi alone. All patients included in the studies were being treated for LGSC in the recurrent setting. Varied results and efficacy of the MEKi were reported in each study. Conclusions: The results highlighted in this systematic review demonstrate varied responses to MEKi for recurrent LGSC. Further research is needed in this field comparing the efficacy to current therapies, as well as to further evaluate the safety and toxicity profile with long-term use of MEKi.

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Section: Discussionmentioning

confidence: 99%

Section: Implications For Practice and Future Researchmentioning

confidence: 99%

Treatment of Recurrent Low-grade Serous Ovarian Cancer With MEK Inhibitors

Kulkarni,

Cooke,

Fazelzad

et al. 2023

American Journal of Clinical Oncology

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“…12,13 There is a growing and promising body of evidence for the efficacy of endocrine, molecularly targeted and anti-angiogenic treatment modalities in both the front-line and recurrent setting. [14][15][16][17] As LGSC is rare and incidence rates are relatively low, randomized controlled trials and retrospective series including large numbers of patients are scarce. In addition, the available studies generally present (1) primary treatment and survival rates without trends over time, (2) crude survival rates instead of relative survival (RS), (3) survival rates subdivided by early-and advanced stage disease instead of FIGO stage I-IV, and (4) outcomes of debulking surgery without differentiating between the primary and interval approach.…”

Section: Introductionmentioning

confidence: 99%

“…In advanced stage disease, debulking surgery with resection of all macroscopic disease (synonym: cytoreductive surgery) is of pivotal importance because of its relative chemoresistance (response rate of 4%–11%) 12,13 . There is a growing and promising body of evidence for the efficacy of endocrine, molecularly targeted and anti‐angiogenic treatment modalities in both the front‐line and recurrent setting 14–17 …”

Section: Introductionmentioning

confidence: 99%

Stage, treatment and survival of low‐grade serous ovarian carcinoma in the Netherlands: A nationwide study

Decker

Wenzel

Bart

et al. 2023

Acta Obstet Gynecol Scand

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Introduction Serous ovarian carcinomas constitute the largest group of epithelial ovarian cancer (60%–75%) and are further classified into high‐ and low‐grade serous carcinoma. Low‐grade serous carcinoma (LGSC) is a relatively rare subtype (approximately 5% of serous carcinomas) and epidemiologic studies of large cohorts are scarce. With the present study we aimed to report trends in stage, primary treatment and relative survival of LGSC of the ovary in a large cohort of patients in an effort to identify opportunities to improve clinical practice and outcome of this relatively rare disease. Material and Methods Patients diagnosed with LGSC between 2000 and 2019 were identified from the Netherlands Cancer Registry (n = 855). Trends in FIGO stages and primary treatment were analyzed with the Cochran–Armitage trend test, and differences in and trends of 5‐year relative survival were analyzed using multivariable Poisson regression. Results Over time, LGSC was increasingly diagnosed as stage III (39.9%–59.0%) and IV disease (5.7%–14.4%) and less often as stage I (34.6%–13.5%; p < 0.001). Primary debulking surgery was the most common strategy (76.2%), although interval debulking surgery was preferred more often over the years (10.6%–31.1%; p < 0.001). Following primary surgery, there was >1 cm residual disease in only 15/252 patients (6%), compared with 17/95 patients (17.9%) after interval surgery. Full cohort 5‐year survival was 61% and survival after primary debulking surgery was superior to the outcome following interval debulking surgery (60% vs 34%). Survival following primary debulking surgery without macroscopic residual disease (73%) was better compared with ≤1 cm (47%) and >1 cm residual disease (22%). Survival following interval debulking surgery without macroscopic residual disease (51%) was significantly higher than after >1 cm residual disease (24%). Except FIGO stage II (85%–92%), survival did not change significantly over time. Conclusions Over the years, LGSC has been diagnosed as FIGO stage III and stage IV disease more often and interval debulking surgery has been increasingly preferred over primary debulking in these patients. Relative survival did not change over time (except for stage II) and worse survival outcomes after interval debulking surgery were observed. The results support the common recommendation to perform primary debulking surgery in patients eligible for primary surgery.

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Hormone maintenance therapy for women with low-grade serous ovarian cancer in the front-line setting: A systematic review

Cited by 2 publications

References 21 publications

Treatment of Recurrent Low-grade Serous Ovarian Cancer With MEK Inhibitors

Treatment of Recurrent Low-grade Serous Ovarian Cancer With MEK Inhibitors

Stage, treatment and survival of low‐grade serous ovarian carcinoma in the Netherlands: A nationwide study

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