Dr. Grisham on Frontline Treatment for Low-Grade Serous Ovarian Cancer

Rachel N. Grisham, medical oncologist, Memorial Sloan Kettering Cancer Center, discusses frontline treatment options for patients with low-grade serous ovarian cancer.

This is a very rare subset of ovarian cancer, Grisham says, with approximately 1300 cases every year in the United States. The low incidence of this disease makes it difficult for investigators to develop effective, personalized therapy. In the upfront setting, there is a GOG study (NRGGY019) that will open soon to investigate the role of chemotherapy in this setting. In the trial, newly diagnosed patients will be randomized to receive either chemotherapy followed by hormonal therapy with letrozole or hormonal therapy with letrozole alone—both following initial surgical resection.

An unanswered question in this space is whether chemotherapy, which has demonstrated meager activity in the frontline setting, can be replaced by hormonal therapy for patients with advanced-stage disease. Grisham says that in the absence of any prospective data, she still recommends upfront chemotherapy for these patients; however, she feels that results from his study will help identify the roles of chemotherapy and hormonal therapy in the upfront setting.