Exploring novel approaches in the systemic therapy of low-grade serous carcinoma of the ovary: a literature review

Abstract

By presenting a comprehensive analysis of low-grade serous carcinomas (LGSCs), a subset of epithelial ovarian cancers, this review delves into their distinct molecular characteristics, clinicopathological features and systemic therapy options, emphasizing their differences from high-grade serous carcinomas (HGSCs). Notably, LGSCs exhibit prevalent RAS/RAF/MEK/MAPK pathway activation, KRAS and BRAF mutations, and infrequent p53 mutations. While chemotherapy is commonly employed, LGSCs display lower responsiveness compared to HGSCs. Hormone therapy, particularly endocrine maintenance therapy, is explored due to the higher estrogen receptor expression. Novel therapeutic approaches involving CDK4/6 inhibitors, MEK inhibitors, and antiangiogenic agents like bevacizumab are also investigated. Ongoing clinical trials are striving to enhance LGSC treatment strategies, offering valuable insights for future therapeutic advancements in this challenging ovarian cancer subtype.

Keywords: low-grade serous carcinoma; molecular features; novel therapeutic options; ovarian cancer; systemic treatment.

FIGURE 1

Critical components of the VEGF, Pl3K/AKT/mTOR, and RAS/RAF/MEK signal transduction pathways, as well as the therapeutic interventions employed to target these pathways. Upon ligand binding, the receptors initiate a cascade of signaling events, which are hyperactive in cancerous cells. The diagram provides a visual representation of the key factors involved in these pathways and highlights the therapeutic agents used to intervene in their aberrant activation. Created with BioRender.com.