Updated 2026 International Consensus on Low-Grade Serous Ovarian Carcinoma

The 2026 Low-Grade Serous Ovarian Carcinoma (LGSOC) Consensus Conference convened an international multidisciplinary panel to update management guidelines across pathology, molecular testing, translational biology, frontline and recurrent treatment, imaging, and survivorship. LGSOC is a rare epithelial malignancy characterized by frequent mitogen-activated protein kinase (MAPK) pathway alterations, hormone receptor expression, relative resistance to cytotoxic chemotherapy, and an indolent but relapsing clinical trajectory.

For frontline management, the updated consensus incorporates data from the NRG-GY019 trial supporting chemotherapy-containing postoperative therapy as the reference approach for stage II–IV disease, while acknowledging select scenarios where endocrine monotherapy may serve as an individualized de-escalation option. For recurrent disease, the recommendations highlight the accelerated approval granted by the US Food and Drug Administration for avutometinib in combination with defactinib in patients with KRAS-mutated LGSOC, alongside emerging evidence supporting the combination of endocrine therapy with CDK4/6 inhibitors.

The consensus panel emphasizes the necessity of multidisciplinary care, central pathology review for clinical trials, and treatment-specific biomarker interpretation. In addition, the framework addresses imaging assessment, toxicity management, and patient-centered survivorship, while outlining priorities for prospective research into treatment sequencing, predictive biomarkers, and quality-of-life outcomes.