Geburtshilfe und Frauenheilkunde, Table of Contents

CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2018; 78(10): 972-976
DOI: 10.1055/a-0717-5411

GebFra Science

Review

Georg Thieme Verlag KG Stuttgart · New York

Low-grade Serous Ovarian Carcinoma

Low-grade seröse Ovarialkarzinome

Enzo Ricciardi^*

¹Gynaecology and Gynaecological Oncology, Kliniken Essen-Mitte, Essen, Germany

,

Thaïs Baert^*

¹Gynaecology and Gynaecological Oncology, Kliniken Essen-Mitte, Essen, Germany

²Department of Oncology, Laboratory of Tumor Immunology and Immunotherapy, ImmunOvar Research Group, KU Leuven, Leuven, Belgium

,

Beyhan Ataseven

¹Gynaecology and Gynaecological Oncology, Kliniken Essen-Mitte, Essen, Germany

,

Florian Heitz

¹Gynaecology and Gynaecological Oncology, Kliniken Essen-Mitte, Essen, Germany

,

Sonia Prader

¹Gynaecology and Gynaecological Oncology, Kliniken Essen-Mitte, Essen, Germany

,

Mareike Bommert

¹Gynaecology and Gynaecological Oncology, Kliniken Essen-Mitte, Essen, Germany

,

Stephanie Schneider

¹Gynaecology and Gynaecological Oncology, Kliniken Essen-Mitte, Essen, Germany

,

Andreas du Bois

¹Gynaecology and Gynaecological Oncology, Kliniken Essen-Mitte, Essen, Germany

,

Philipp Harter

¹Gynaecology and Gynaecological Oncology, Kliniken Essen-Mitte, Essen, Germany

› Author Affiliations

Hebammen

Abstract

In 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.

Zusammenfassung

Kurz nach der Jahrtausendwende wurde ein 2-stufiges Klassifizierungssystem zur Einstufung von serösen Ovarialkarzinomen eingeführt. Seither wird zunehmend akzeptiert, dass das Low-grade seröse Ovarialkarzinom (LGSOC) eine eigenständige Einheit mit eigener Mutationslandschaft und klinischem Verhalten bildet. Weniger als 10% aller serösen Karzinome des Ovars werden dem Low-Grade-Subtyp zugeordnet, und in den klinischen Studien zum Ovarialkrebs tritt diese Form nur in wenigen Patientinnen auf. Die aktuelle Therapie für das LGSOC basiert daher auf den Ergebnissen kleinerer Studien und retrospektiver Serien sowie auf der Subgruppenanalyse von großen klinischen Studien zum Ovarialkarzinom. Die operative Therapie spielt eine wichtige Rolle für die Behandlung von Patientinnen mit LGSOC. Bei der systemischen Therapie des LGSOC scheinen sowohl hormonelle Therapien als auch gezielte Therapien eine wichtige Rolle zu spielen.

Key words

Key words

ovarian cancer - low-grade serous - rare tumour

Schlüsselwörter

Schlüsselwörter

Ovarialkarzinom - Low-grade serös - seltener Tumor

References
1 Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J. et al. Cancer incidence and mortality patterns in Europe: Estimates for 40 countries in 2012. Eur J Cancer 2013; 49: 1374-1403 doi:10.1016/j.ejca.2012.12.027
2 Kurman R, Ellenson LH, Ronnett BM. Blausteinʼs Pathology of the female genital Tract. 6th ed. Berlin, Heidelberg: Springer; 2011
3 Malpica A, Deavers MT, Lu K. et al. Grading ovarian serous carcinoma using a two-tier system. Am J Surg Pathol 2004; 28: 496-504
4 Kaldawy A, Segev Y, Lavie O. et al. Low-grade serous ovarian cancer: A review. Gynecol Oncol 2016; 143: 433-438 doi:10.1016/j.ygyno.2016.08.320
5 Gershenson DM, Bodurka DC, Lu KH. et al. Impact of age and primary disease site on outcome in women with low-grade serous carcinoma of the ovary or peritoneum: Results of a large single-institution registry of a rare tumor. J Clin Oncol 2015; 33: 2675-2682
6 Peres LC, Cushing-Haugen KL, Köbel M. et al. Invasive Epithelial Ovarian Cancer Survival by Histotype and Disease Stage. J Natl Cancer Inst 2018;
7 Gershenson DM, Sun CC, Wong KK. Impact of mutational status on survival in low-grade serous carcinoma of the ovary or peritoneum. Br J Cancer 2015; 113: 1254-1258 doi:10.1038/bjc.2015.364
8 Wong KK, Gershenson D. The continuum of serous ovarian tumors of low malignant potential and low-grade serous carcinoma of the ovary. Dis Markers 2007; 23: 377-387
9 Bonome T, Lee JY, Park DC. et al. Expression profiling of serous low malignant potential, low-grade, and high-grade tumors of the ovary. Cancer Res 2005; 65: 10602-10612
10 Hauptmann S, Friedrich K, Redline R. et al. Ovarian borderline tumors in the 2014 WHO classification: evolving concepts and diagnostic criteria. Virchows Arch 2017; 470: 125-142
11 Kurman RJ, Shih IM. The origin and pathogenesis of epithelial ovarian cancer: A proposed unifying theory. Am J Surg Pathol 2010; 34: 433-443
12 Wong KK, Tsang YTM, Deavers MT. et al. BRAF mutation is rare in advanced-stage low-grade ovarian serous carcinomas. Am J Pathol 2010; 177: 1611-1617 doi:10.2353/ajpath.2010.100212
13 Kuo KT, Guan B, Feng Y. et al. Analysis of DNA copy number alterations in ovarian serous tumors identifies new molecular genetic changes in low-grade and high-grade carcinomas. Cancer Res 2009; 69: 4036-4042 doi:10.1158/0008-5472.CAN-08-3913
14 Wong KK, Lu KH, Malpica A. et al. Significantly greater expression of ER, PR, and ECAD in advanced-stage low-grade ovarian serous carcinoma as revealed by immunohistochemical analysis. Int J Gynecol Pathol 2007; 26: 404-409
15 Norquist BM, Harrell MI, Brady MF. et al. Inherited mutations in women with ovarian carcinoma. JAMA Oncol 2016; 2: 482-490
16 Fader AN, Java J, Ueda S. et al. Survival in women with grade 1 serous ovarian carcinoma. Obstet Gynecol 2013; 122: 225-232
17 Grabowski JP, Harter P, Heitz F. et al. Operability and chemotherapy responsiveness in advanced low-grade serous ovarian cancer. An analysis of the AGO Study Group metadatabase. Gynecol Oncol 2016; 140: 457-462
18 Fader AN, Bergstrom J, Jernigan A. et al. Primary cytoreductive surgery and adjuvant hormonal monotherapy in women with advanced low-grade serous ovarian carcinoma: Reducing overtreatment without compromising survival?. Gynecol Oncol 2017; 147: 85-91 doi:10.1016/j.ygyno.2017.07.127
19 Gershenson DM, Sun CC, Lu KH. et al. Clinical behavior of stage II–IV low-grade serous carcinoma of the ovary. Obstet Gynecol 2006; 108: 361-368
20 Ledermann JA, Raja FA, Fotopoulou C. et al. Newly diagnosed and relapsed epithelial ovarian carcinoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013;
21 Gershenson DM, Sun CC, Bodurka D. et al. Recurrent low-grade serous ovarian carcinoma is relatively chemoresistant. Gynecol Oncol 2009; 114: 48-52 doi:10.1016/j.ygyno.2009.03.001
22 Schmeler KM, Sun CC, Bodurka DC. et al. Neoadjuvant chemotherapy for low-grade serous carcinoma of the ovary or peritoneum. Gynecol Oncol 2008; 108: 510-514
23 Oza AM, Cook AD, Pfisterer J. et al. Standard chemotherapy with or without bevacizumab for women with newly diagnosed ovarian cancer (ICON7): overall survival results of a phase 3 randomised trial. Lancet Oncol 2015; 16: 928-936
24 Gershenson DM, Bodurka DC, Coleman RL. et al. Hormonal maintenance therapy for women with low-grade serous cancer of the ovary or peritoneum. J Clin Oncol 2017; 35: 1103-1111
25 Gordon AN, Fleagle JT, Guthrie D. et al. Recurrent Epithelial Ovarian Carcinoma: A Randomized Phase III Study of Pegylated Liposomal Doxorubicin Versus Topotecan. J Clin Oncol 2001; 19: 3312-3322 doi:10.1200/JCO.2001.19.14.3312
26 Gershenson DM. Low-grade serous carcinoma of the ovary or peritoneum. Ann Oncol 2016; 27: i45-i49
27 du Bois A, Vergote I, Ferron G. et al. Randomized controlled phase III study evaluating the impact of secondary cytoreductive surgery in recurrent ovarian cancer: AGO DESKTOP III/ENGOT ov20. J Clin Oncol 2017; 35: 5501 doi:10.1200/JCO.2017.35.15_suppl.5501
28 Crane EK, Sun CC, Ramirez PT. et al. The role of secondary cytoreduction in low-grade serous ovarian cancer or peritoneal cancer. Gynecol Oncol 2015; 136: 25-29 doi:10.1016/j.ygyno.2014.11.005
29 Rose PG, Radeva M, Michener CM. et al. Efficacy of pegylated liposomal doxorubicin in low-grade serous ovarian carcinoma. Int J Gynecol Cancer 2017; 27: 907-911 doi:10.1016/j.ygyno.2017.03.497
30 Pujade-Lauraine E, Ledermann JA, Selle F. et al. Olaparib tablets as maintenance therapy in patients with platinum-sensitive, relapsed ovarian cancer and a BRCA1/2 mutation (SOLO2/ENGOT-Ov21): a double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Oncol 2017; 18: 1274-1284
31 Mirza MR, Monk BJ, Herrstedt J. et al. ENGOT-OV16/NOVA Investigators. Niraparib Maintenance Therapy in Platinum-Sensitive, Recurrent Ovarian Cancer. N Engl J Med 2016; 375: 2154-2164 doi:10.1056/NEJMoa1611310
32 Coleman RL, Oza AM, Lorusso D. et al. Rucaparib maintenance treatment for recurrent ovarian carcinoma after response to platinum therapy (ARIEL3): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet 2017; 390: 1949-1961
33 Schmeler K, Tao X, Sun C. et al. Encouraging responses with bevacizumab in recurrent low-grade serous ovarian cancer. J Clin Oncol 2010; 28 (Suppl. 15) e15503 doi:10.1200/jco.2010.28.15_suppl.e15503
34 Dalton HJ, Fleming ND, Sun CC. et al. Activity of bevacizumab-containing regimens in recurrent low-grade serous ovarian or peritoneal cancer: A single institution experience. Gynecol Oncol 2017; 145: 37-40 doi:10.1016/j.ygyno.2017.01.027
35 Rose PG, Mahdi H, Jernigan A. et al. Activity of Bevacizumab in Patients with Low-Grade Serous Ovarian Carcinoma. Int J Gynecol Cancer 2016; 26: 1048-1052
36 Grisham RN, Iyer G, Sala E. et al. Bevacizumab shows activity in patients with low-grade serous ovarian and primary peritoneal cancer. Int J Gynecol Cancer 2014; 24: 1010-1014
37 Gershenson DM, Sun CC, Iyer RB. et al. Hormonal therapy for recurrent low-grade serous carcinoma of the ovary or peritoneum. Gynecol Oncol 2012; 125: 661-666 doi:10.1016/j.ygyno.2011.12.080
38 Farley J, Brady WE, Vathipadiekal V. et al. Selumetinib in women with recurrent low-grade serous carcinoma of the ovary or peritoneum: an open-label, single-arm, phase 2 study. Lancet Oncol 2013; 14: 134-140 doi:10.1016/S1470-2045(12)70572-7