Do Patients With Low-Grade Serous Ovarian Carcinoma Benefit From Targeted Sequencing?
Posted: Monday, January 7, 2019
According to a discussion of two case reports, published in the Journal of Clinical Oncology Precision Oncology, next-generation sequencing may benefit patients with recurrent low-grade serous ovarian cancer as a clinical management tool. Such sequencing may help “to inform selection of targeted agents and, more broadly, to identify rational targeted agents and combinations to treat recurrent disease,” noted Ursula A. Matulonis, MD, of the Dana-Farber Cancer Institute, and colleagues.
The authors evaluated the outcomes of two patients with recurrent low-grade serous ovarian cancer, whose treatment decisions were informed by targeted sequencing of formalin-fixed tumor samples. The OncoPanel test reports mutations, variations in copy number and structure, as well as insertions and deletions in more than 300 cancer-associated genes.
As a result of sequencing, one of the patients was found to have a BRAF V600E mutation. Thus, the patient was started on vemurafenib treatment (480 mg twice daily, which was reduced to 240 mg twice daily after cutaneous toxicity). At a follow-up of 20 months, the patient continues this dosage and shows no evidence of disease progression or new side effects.
The second patient had undergone secondary cytoreduction and platinum-based chemotherapy for recurrent disease and since maintained a stable response to hormonal therapy for almost 5 years. However, she developed an isolated progressive lesion. The OncoPanel test revealed that the tumor had an ESR1 Y537S mutation, which is associated with resistance to antiestrogen therapy. In this case, sequencing helped to identify the point of resistance, which may be a factor in selecting additional treatment for this patient.
Disclosure: The study authors’ disclosure information can be found at ascopubs.org.