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Targeting BRAF pathway in low-grade serous ovarian cancer
Chiara Perrone1, Roberto Angioli2, Daniela Luvero2
1Department of Gynecological, Obstetrical and Urological Sciences, Sapienza University of Rome, Rome, Italy.
Abstract:
Mutations in genes encoding for proteins along the RAS-RAF-MEK-ERK pathway have been detected in a variety of tumor entities including ovarian carcinomas. In the recent years, several inhibitors of this pathway have been developed, whose antitumor potential is currently being assessed in different clinical trials. Low grade serous ovarian carcinoma, is a rare gynecological tumor which shows favorable overall survival, compared to the general ovarian cancer population, but worrying resistance to conventional chemotherapies. The clinical behavior of low grade serous ovarian carcinoma reflects the different gene profile compared to high-grade serous carcinoma: KRAS/BRAF mutations. BRAF inhibitors as single agents were approved for the treatment of BRAF mutated tumors. Nevertheless, many patients face progressive disease. The understanding of the mechanisms of resistance to BRAF inhibitors therapy and preclinical studies showing that BRAF and mitogen-activated protein kinase kinase (MEK) inhibitors combined therapy delays the onset of resistance compared to BRAF inhibitor single agent, led to the clinical investigation of combined therapy. The aim of this paper is to review the efficacy and safety of the combination of BRAF plus MEK inhibitors on ovarian carcinomas, in particularly focusing on low grade serous ovarian carcinoma.
Insights
Targeted therapy combining BRAF and MEK inhibitors shows promise for ovarian carcinomas, particularly low-grade serous ovarian carcinoma, addressing resistance to conventional treatments.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- RAS-RAF-MEK-ERK pathway mutations are implicated in various cancers, including ovarian carcinomas.
- Low-grade serous ovarian carcinoma (LGSOC) exhibits resistance to standard chemotherapy despite favorable survival rates.
- Specific genetic profiles, such as KRAS/BRAF mutations, differentiate LGSOC from high-grade serous carcinoma.
Purpose of the Study:
- To review the efficacy and safety of combined BRAF and MEK inhibitor therapy in ovarian carcinomas.
- To specifically focus on the application of this combination therapy in LGSOC.
- To explore potential mechanisms of resistance and therapeutic strategies.
Main Methods:
- Literature review of preclinical studies and clinical trials.
- Analysis of data on BRAF and MEK inhibitor combinations.
- Focus on studies involving ovarian carcinoma patients, especially LGSOC.
Main Results:
- BRAF inhibitors are approved for BRAF-mutated tumors, but resistance is a concern.
- Combined BRAF and MEK inhibition has shown potential in preclinical models to delay resistance.
- Clinical investigation of combination therapy is ongoing for ovarian carcinomas.
Conclusions:
- Combined BRAF and MEK inhibitors represent a promising therapeutic strategy for ovarian carcinomas, including LGSOC.
- This approach may overcome resistance mechanisms associated with single-agent BRAF inhibition.
- Further clinical evaluation is crucial to establish the safety and efficacy profile of this combination therapy.
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