Biological Role and Clinical Implications of Mutation in Rhabdomyosarcoma.

Major progress in recent decades has furthered our clinical and biological understanding of rhabdomyosarcoma (RMS) with improved stratification for treatment based on risk factors. Clinical risk factors alone were used to stratify patients for treatment in the European Pediatric Soft Tissue Sarcoma Study Group (EpSSG) RMS 2005 protocol. The current EpSSG overarching study for children and adults with frontline and relapsed rhabdomyosarcoma (FaR-RMS NCT04625907) includes fusion gene status in place of histology as a risk factor. Additional molecular features of significance have recently been recognized, including the gene mutation. Here, we review biological information showing that blocks cell differentiation and has a MYC-like activity that enhances tumorigenesis and is linked to an aggressive cellular phenotype. mutations can be found together with mutations in other genes, such as , as potentially cooperating events. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, ten publications in the clinical literature involving 72 cases were reviewed. mutation in RMS can occur in both adults and children and is frequent in sclerosing/spindle cell histology, although it is also significantly reported in a subset of embryonal RMS. mutated tumors most frequently arise in the head and neck and extremities and are associated with poor outcome, raising the issue of how to use in risk stratification and how to treat these patients most effectively.