Sustained response to vemurafenib in a low grade serous ovarian cancer with a BRAF V600E mutation.
Low-grade serous ovarian adenocarcinomas (LGSOC) make up approximately 10 % of serous ovarian carcinomas. While rarely aggressive, this slow-growing tumor is well known to respond poorly to chemotherapy. Specific treatments for this ovarian subtype are lacking, with the same global approaches used for high grade cases being applied for LGSOC patients. LGSOCs have been reported to have a specific genetic profile, with notable implication of the MAPK pathway. This has opened up opportunities for novel therapeutic strategies, with in particular the use of targeted therapies. We report here the case of a heavily pretreated unresectable BRAF p.V600E-mutated LGSOC, which we treated vemurafenib, a BRAF inhibitor specific for V600E mutations. We saw impressive efficacy, with a long-term partial response along with CA125 reductions and symptom relief. Although this mutation is present in LGSOC at very a low incidence, we recommend routine testing for BRAF and other targetable mutations in this patient population, along with further evaluation in the increasingly popular basket trial approach.
Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015, Paris, France. pierre.combe@aphp.fr.|Faculté de médecine Paris-Descartes, Paris 5, France. pierre.combe@aphp.fr.
Pierre
P
Combe
Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015, Paris, France.
Laure
L
Chauvenet
Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015, Paris, France.
Marie-Aude
MA
Lefrère-Belda
Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015, Paris, France.
Hélène
H
Blons
Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015, Paris, France.
Caroline
C
Rousseau
Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015, Paris, France.|Faculté de médecine Paris-Descartes, Paris 5, France.
Stéphane
S
Oudard
Centre des cancers de la femme et recherche clinique, GH Paris Centre, site Hôtel-Dieu, 1 place du Parvis Notre-Dame, 75181, Paris cedex 04, France.
Eric
E
Pujade-Lauraine
D000368:Aged; D018284:Cystadenocarcinoma, Serous / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics*; D005260:Female; D006801:Humans; D007211:Indoles / Q000494:pharmacology / Q000627:therapeutic use*; D009154:Mutation / Q000235:genetics*; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics*; D048493:Proto-Oncogene Proteins B-raf / Q000037:antagonists & inhibitors / Q000235:genetics*; D013449:Sulfonamides / Q000494:pharmacology / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D000077484:Vemurafenib
D007211:Indoles; D013449:Sulfonamides; D000077484:Vemurafenib; C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf
BRAF; Basket trial; Low grade serous ovarian cancer; Vemurafenib