Question asked by: 
Guest at Being Together Hertfordshire
Date asked: 
Nov 2016

What research is being carried out for low-grade serous ovarian cancer?

What research is being carried out for low-grade serous ovarian cancer?
Ovarian cancer is separated into different cell types. The most common one is high grade serous, and we also have mucinous, clear-cell, and low-grade
Response by Guest Expert Being Together Hertfordshire: Dr Rebecca Kristeleit

Ovarian cancer is separated into different cell types.  The most common one is high grade serous, and we also have mucinous, clear-cell, and low-grade.  The reason we group women, or label cancers, with these different cell types is because they behave differently.  The prognosis is different, the response to treatment is different, the molecular causes of the cancers are different so you have to have a very different approach in treatment, often, and particularly for low-grade serous cancers. 

The surgeons, although they’re very important for high-grade serous disease, they’re particularly important for low-grade serous disease, because it tends to be an ovarian cancer subtype that is less sensitive to chemotherapy.  So if you can operate, that’s usually the right answer, until it gets to a point where surgery really is not feasible.

There’s a trial called LOGS, which is for low-grade ovarian cancer, it’s a phase II/III study, and it’s looking at a randomisation between standard chemotherapy (single-agent chemotherapy), versus a new class of targeted drugs called MEK inhibitors (MEK inhibitors are tablets). 

If you’re a woman who’s got low-grade ovarian cancer, you happen to have been through a study for low-grade ovarian cancer, the next step I would suggest, if surgery’s not an option, and maybe chemotherapy’s not working for you, is to consider endocrine therapy.  Or ask your doctor to consider endocrine therapy, and they can look at hormone receptor status in your cancer.

The other thing is to consider referral to a phase I unit and maybe have molecular testing of your tumour, because that can bring up new targets, and we may have very new drugs in a phase I clinic that might be suitable for you.