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Low-grade Serous Ovarian — SCE Medical Oncology MCQ

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ModerateGynaecological CancersLow-grade Serous OvarianSCE Medical Oncology

A 45-year-old woman with recurrent low-grade serous ovarian cancer (LGSOC, KRAS/BRAF wild-type) has progressed on multiple lines of chemotherapy. What hormonal therapy can be offered?

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Correct answer: A — Aromatase inhibitor (letrozole or anastrozole) — LGSOC often expresses ER and responds to hormonal therapy

Low-grade serous ovarian cancer (LGSOC) is a distinct entity from high-grade serous — it is typically chemoresistant but often ER-positive and hormone-responsive. Aromatase inhibitors (letrozole, anastrozole) achieve clinical benefit rates of approximately 50-70% with prolonged disease stabilisation. MEK inhibitors (trametinib, binimetinib) also have activity, particularly in KRAS-mutant LGSOC. The MILO/ENGOT-ov11 and GOG-0281 trials evaluated MEK inhibitors in this subtype.

Reference: ESMO 2024 Ovarian Cancer Guidelines; Gershenson et al JCO 2012