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Review
. 2013 Feb 1;119(3):474-6.
doi: 10.1002/cncr.27833. Epub 2012 Dec 11.

Ovarian cancer : making its own rules-again

Elise C Kohn, Jean Hurteau
Review

Ovarian cancer : making its own rules-again

Elise C Kohn et al. Cancer. .

Abstract

Epithelial ovarian cancer, once categorizing all epithelial cancers of the ovary and fallopian tube, is now recognized to be an umbrella term. We are recognizing two categories of ovarian cancer, with the “type 1” cancers containing further types, including low grade serous cancers, mucinous, clear cell, and low grade endometrioid. These types are genetically and histologically as different as is their outcome. The paper accompanying this editorial further dissects low grade serous cancers to show that those carrying oncogenic KRAS or BRAF mutations have an unexpectedly excellent clinical outcome. We discuss this newest unexpected behavior of ovarian cancer.

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Figures

Figure 1
Figure 1. Epithelial ovarian cancers are now divided into two categories
Type 1 cancers are now recognized to have 4 types, low grade serous, low grade endometrioid, clear cell, and mucinous histologies. Type 2 cancers include in one unit, both the high grade serous and now most agree, also the high grade endometrioid histologies.
Figure 2
Figure 2. RAF→RAS signaling
Receptor tyrosine kinases (RTK) signal through Srchomology-2 domains to Src. It in turn activates the pathway to KRAS, RAF, to ultimately activate the mitogen-activated kinase, MAPK, pathway via MEK to ERK. An activating mutation in KRAS (shown in red), such as the codon 12 and 13 mutations described in low grade serous ovarian cancer, can drive downstream activation of the MAPK pathway without upstream the otherwise needed upstream stimulation by RTK. Similarly, an activating mutation in BRAF (shown in green), such as V600E
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