Complete response with combined BRAF and MEK inhibition in BRAF mutated advanced low-grade serous ovarian carcinoma

Bengt  Tholander; Anthoula  Koliadi; Johan  Botling; Hanna  Dahlstrand; Anne  Von Heideman; Håkan  Ahlström; Kjell Öberg; Gustav J.  Ullenhag

doi:10.1080/03009734.2020.1826612

Bengt Tholander Department of Oncology, Uppsala University Hospital, Uppsala, Sweden; Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
Anthoula Koliadi Department of Oncology, Uppsala University Hospital, Uppsala, Sweden; Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
Johan Botling Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
Hanna Dahlstrand Department of Oncology, Uppsala University Hospital, Uppsala, Sweden; Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
Anne Von Heideman Department of Oncology, Uppsala University Hospital, Uppsala, Sweden; Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
Håkan Ahlström Department of Surgical Sciences, Uppsala Sweden, Division of Radiology, Uppsala University Hospital, Uppsala, Sweden
Kjell Öberg Department of Oncologic Endocrinology, Uppsala University Hospital, Uppsala, Sweden; Department of Medical Sciences, Uppsala University, Uppsala, Sweden
Gustav J. Ullenhag Department of Oncology, Uppsala University Hospital, Uppsala, Sweden; Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden;

DOI: https://doi.org/10.1080/03009734.2020.1826612

Keywords: BRAF inhibitor, chemotherapy, low-grade serous ovarian cancer, MEK inhibitor, next-generation sequencing, surgery, targeted therapy, V600E mutation

Abstract

More effective treatments are needed for low-grade serous ovarian carcinoma (LGSOC). Our patient, who suffers from metastatic LGSOC, had received all established treatments. Sequencing analysis revealed an activating BRAF mutation. Therefore, combined treatment with BRAF and MEK inhibitors, which is the gold standard in malignant melanoma, was initiated. After eight months of therapy, the response was assessed as complete and the treatment is still, 3.5 years after initiation, of benefit. To our knowledge, no complete response on combined BRAF and MEK inhibitor treatment of low-grade serous ovarian cancer has previously been reported.

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