Association of Anti-EGFR Antibody and MEK Inhibitor in Gynecological Cancer Harboring RAS Mutation: A Case Series.

Fiche publication


Date publication

mars 2022

Journal

International journal of molecular sciences

Auteurs

Membres identifiés du Cancéropôle Est :
Dr ARNOULD Laurent, Dr BOIDOT Romain, Pr GHIRINGHELLI François, Dr FAVIER Laure, Dr DERANGERE Valentin


Tous les auteurs :
Niogret J, Derangère V, Richard C, Nuttin L, Ghiringhelli F, Favier L, Lefevre LB, Bergeron A, Arnould L, Boidot R

Résumé

Low-grade serous carcinoma represents a minority of serous carcinoma. Although they have better prognosis than high-grade serous carcinoma, they respond poorly to chemotherapy. Thus, it appears necessary to find other treatments such as targeted therapies. Since or mutations occur frequently in low-grade serous carcinoma and lead to constitutively activated MAPK cascade, MEK inhibition should be effective in the treatment of low-grade serous carcinoma. So, we wanted to evaluate the clinical benefit of MEK inhibitors in the management of advanced-stage low-grade serous carcinoma harboring or mutation. We report a case series of three women with advanced-stage low-grade serous carcinoma harboring mutation who had stabilization of their disease during several months under targeted therapy combining anti-EGFR antibody and MEK inhibitor. We performed in vitro experiments, confirming the effectiveness of MEK inhibitor on the -mutated OVCAR-5 cell line, and the constitutively activation of MAPK cascade in -mutated carcinoma. However, it seems that the anti-EGFR antibody does not provide any additional benefit. After whole exome analysis is carried out on the patient with the shortest response, we observed the appearance of RB1 loss-of-function mutation that could be a mechanism of resistance to MEK inhibitors in - of -mutated cancers. The MEK inhibitor is effective in the advanced stages of low-grade serous carcinoma harboring mutation with acceptable tolerance. RB1 loss could be a mechanism of resistance to MEK inhibitors in -mutated low-grade serous carcinoma.

Mots clés

MEK inhibitors, RAS mutation, low-grade serous ovarian carcinoma

Référence

Int J Mol Sci. 2022 Mar 19;23(6):