The two most common subtypes of cervical cancer harbor high rates of potentially targetable oncogenic mutations, study results suggest.
Because cervical adenocarcinomas and squamous cell carcinoma feature distinct molecular profiles, personalized treatment strategies could significantly improve outcomes, researchers wrote.
“We have historically treated cervical cancers as one disease,” Alexi Wright, MD, MPH, a medical oncologist at the Susan F. Smith Center for Women’s Cancers at Dana-Farber Cancer Institute and an instructor in medicine at Harvard Medical School, said in a press release. “However, our findings suggest that some patients may be at higher risk of dying from their disease and might benefit from a more tailored treatment approach.”
Wright and colleagues analyzed DNA from 80 cervical cancer tumors — 40 adenocarcinomas and 40 squamous cell carcinomas. They used the OncoMap system to search for 1,250 mutations in 139 cancer genes.
Overall, they found PIK3CA mutations in 31% of tumors, including 25% of adenocarcinomas and 37.5% of squamous cell carcinomas (P=.33). They identified KRAS mutations in 17.5% of adenocarcinomas but none of the squamous cell carcinomas (P=.01). They identified a rare EGFR mutation in 7.5% of squamous cell carcinomas but none of the adenocarcinomas (P=.24).
Results of an adjusted analyses showed PIK3CA mutations were associated with shorter survival (67.1 months vs. 90.3 months; HR= 9.1; 95% CI, 2.8-29.5).
“While current treatment strategies don’t take into account whether cervical tumors are adenocarcinomas or squamous cell carcinomas, our study suggests that identifying and targeting distinct subsets of patients may improve outcomes for women with early- or late-stage disease,” Wright said.
Disclosure: The study was funded by the American Cancer Society, ASCO’s Conquer Cancer Foundation, the Team Maureen Cervical Cancer Fund and the Friends of Dana-Farber Cancer Institute. The researchers report consultant roles with Eisai, Foundation Medicine, Novartis and Sanofi-Aventis; employment relationships with Janssen and Novartis; and stock ownership in Foundation Medicine.