Controversies in the management of mesonephric and mesonephric-like adenocarcinomas of the female genital tract Review
| Authors: | Praiss, A.; Park, K.; Makker, S.; Girshman, J.; Aghajanian, C.; Grisham, R. N. |
| Review Title: | Controversies in the management of mesonephric and mesonephric-like adenocarcinomas of the female genital tract |
| Abstract: | Mesonephric and mesonephric-like adenocarcinomas of the gynecologic tract are a rare subset of gynecologic tumors that are frequently associated with the presence of somatic KRAS mutations. Owing to their rare nature and ability to arise in different gynecologic sites, pathologic diagnosis is often challenging and under-represented. Immunohistochemistry and routine use of next-generation sequencing has allowed these cases to be more readily identified; however, there is still a paucity of clinical outcomes data, and the efficacy of treatment paradigms remains largely unknown. Historically, mesonephric and mesonephric-like adenocarcinomas were considered to be less responsive to systemic treatment, but response rates to first-line platinum-doublet chemotherapy for metastatic disease may be higher than initially suspected. Recurrent disease is often distant and located in the lungs, suggesting an important role of surveillance chest imaging. Given that most of these tumors are associated with somatic mitogen-activated protein kinase pathway mutations, a currently open phase II trial is assessing the dual RAF/MEK clamp avutometinib in combination with the FAK inhibitor defactinib in patients with recurrent mesonephric and mesonephric-like adenocarcinomas. Continued multi-institutional prospective trials are necessary to elucidate additional treatment options for these rare tumors. © 2025 European Society of Gynaecological Oncology and the International Gynecologic Cancer Society |
| Keywords: | immunohistochemistry; mitogen activated protein kinase; adult; clinical article; aged; review; systemic therapy; phase 2 clinical trial; drug combination; diagnosis; kras; drug therapy; therapy; mapk; female genital system; clinical outcome; high throughput sequencing; mesonephros; human; female; defactinib; mesonephric; mesonephric-like; avutometinib |
| Journal Title: | International Journal of Gynecological Cancer |
| Volume: | 35 |
| Issue: | 3 |
| ISSN: | 1048-891X |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2025-03-01 |
| Start Page: | 101638 |
| Language: | English |
| DOI: | 10.1016/j.ijgc.2025.101638 |
| PROVIDER: | scopus |
| PUBMED: | 39914268 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: Rachel N. Grisham -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
-
308Park -
170Grisham -
609Aghajanian -
31Girshman -
36Praiss
Related MSK Work