Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA.
Cancer Med. 2021 Nov;10(22):8238-8250. doi: 10.1002/cam4.4247. Epub 2021 Nov 2.
Patients with high-intermediate risk endometrial cancer (H-IR EMCA) have an elevated risk of recurrence compared to low-risk counterparts. Many H-IR EMCA patients are treated with radiation or chemotherapy, but their overall survival is not significantly impacted by treatment. The objective of this study was to compare molecular profiles of H-IR EMCA patients with disease recurrence to those without to identify characteristics that could better predict patient outcomes.
Tissue was acquired from H-IR EMCA patients with disease recurrence (n=15) and without disease recurrence (n=15) who had not received adjuvant therapy and performed DNA and RNA analyses.
In recurrent population, 5 patients had matchingrecurrent and initial tumor tissues. Of note, 5/7 (71%) African Americanpatients had disease recurrence compared to 10/23 (43%) White patients. Inaddition, several new mutations were found in individual patient's recurrentcompared to initial tumors.
Currently the treatment ofendometrial cancer is rapidly changing with molecular profiling becoming partof the standard of care. Additionally, it and is being incorporated intoclinical trials in this group of patients. The specific gene mutations and RNAexpression signatures that were observed in our small cohort need to bevalidated in larger cohorts to determine their impact.
与低危患者相比,中高危子宫内膜癌(H-IR EMCA)患者的复发风险较高。许多 H-IR EMCA 患者接受放疗或化疗,但治疗对其整体生存率没有显著影响。本研究的目的是比较有疾病复发和无疾病复发的 H-IR EMCA 患者的分子谱,以确定可更好预测患者结局的特征。
从未接受辅助治疗且未发生疾病复发的 H-IR EMCA 患者(n=15)和有疾病复发的患者(n=15)中采集组织,进行 DNA 和 RNA 分析。
在复发人群中,有 5 例患者的复发肿瘤和初始肿瘤组织匹配。值得注意的是,71%(5/7)的非裔美国患者发生了疾病复发,而白种患者的比例为 43%(10/23)。此外,在个别患者的复发性肿瘤中发现了一些新的突变。
目前,子宫内膜癌的治疗正在迅速改变,分子谱分析已成为标准治疗的一部分。此外,它也被纳入了这组患者的临床试验中。在我们的小队列中观察到的特定基因突变和 RNA 表达特征需要在更大的队列中进行验证,以确定其影响。