Treatment Sequencing in Recurrent Low-Grade Serous Ovarian Cancer: A Case-Based Expert Discussion-Treatment Sequencing in Recurrent Low-Grade Serous Ovarian Cancer

Treatment Sequencing in Recurrent Low-Grade Serous Ovarian Cancer

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Video Summary

The discussion focused on management of low-grade serous ovarian cancer using a young patient case. Panelists agreed that because neoadjuvant chemotherapy is generally ineffective in low-grade disease, primary upfront debulking surgery is preferred, even in a 28-year-old. After complete resection, the current standard supported by GY019 is carboplatin/paclitaxel followed by letrozole maintenance, rather than letrozole alone.  <br /><br />For recurrent disease, treatment choice depends on biomarkers and prior therapy. The panel emphasized that liquid biopsy is unreliable for KRAS testing in this tumor type, so tissue-based NGS is preferred. Options discussed included trametinib, bevacizumab-based regimens, mirvetuximab for folate receptor alpha–positive disease, and the combination of avutometinib plus defactinib, which can work even after prior MEK inhibitor exposure. They also reviewed common toxicities, especially rash, diarrhea, edema, ocular toxicity, and CK elevation, plus the importance of dose holds, supportive care, and drug interaction checks.

Keywords

low-grade serous ovarian cancer

upfront debulking surgery

carboplatin paclitaxel

letrozole maintenance

tissue-based NGS

avutometinib defactinib