Division of Gynecologic Oncology, University of Toronto, Toronto, ON, Canada.
Division of Gynecologic Oncology, Sunnybrook, Health Sciences Centre, Odette Cancer Centre, Toronto, ON, Canada.
Curr Oncol Rep. 2022 Nov;24(11):1531-1539. doi: 10.1007/s11912-022-01316-x. Epub 2022 Aug 10.
The goal of this paper was to summarize the recent evidence on rare subtypes of cervical cancer including small-cell carcinoma of the cervix (SCCC), gastric-type adenocarcinoma, and carcinosarcoma.
All three cervical cancer subtypes are aggressive with poor treatment response and high recurrence rates. Molecular studies have identified various actionable mutations in both SCCC (PIK3CA, MYC, TP53, PTEN, ARID1A, KRAS, BRCA2) and gastric-type adenocarcinoma (KRAS, ARID1A, PTEN). While there are a limited number of case reports demonstrating a favorable response for recurrent SCCC to immune checkpoint inhibitors, a larger case series failed to show benefit. The checkpoint inhibitors role in gastric-type adenocarcinoma and carcinosarcoma is yet to be determined. Ninety-one percent of SCCC cases show PARP expression, suggesting a possible role for PARP inhibitors; however, this has yet to be examined in future clinical trials. More studies are needed, with a focus on targeted therapies. The role of PARP inhibitors in SCCC is potentially promising, but significant collaboration between centers/groups will be required to achieve this.
本文旨在总结包括宫颈小细胞癌(SCCC)、胃型腺癌和癌肉瘤在内的罕见宫颈癌亚型的最新证据。
所有三种宫颈癌亚型侵袭性强,治疗反应差,复发率高。分子研究在 SCCC(PIK3CA、MYC、TP53、PTEN、ARID1A、KRAS、BRCA2)和胃型腺癌(KRAS、ARID1A、PTEN)中均发现了多种可靶向的突变。尽管有少数病例报告表明免疫检查点抑制剂对复发性 SCCC 有较好的反应,但更大的病例系列未能显示获益。检查点抑制剂在胃型腺癌和癌肉瘤中的作用仍有待确定。91%的 SCCC 病例显示 PARP 表达,提示 PARP 抑制剂可能具有一定作用;然而,这仍有待未来临床试验进一步研究。需要开展更多研究,重点关注靶向治疗。PARP 抑制剂在 SCCC 中的作用具有很大的应用潜力,但需要中心/团体之间的密切合作才能实现这一目标。