Distribution of genetic alterations in high-risk early-stage cervical cancer patients treated with postoperative radiation therapy

Abstract Somatic genetic alteration analysis was performed for post-hysterectomy high-risk early-stage uterine cervical cancer patients who underwent post-operative radiation therapy. Post-operative radiation therapy was performed for patients with pathological features of pelvic lymph node metastas...

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Main Authors: Naoya Murakami, Yuka Asami, Hiroshi Yoshida, Daisuke Takayanagi, Sou Hirose, Ikumi Kuno, Kazuaki Takahashi, Maiko Matsuda, Yoko Shimada, Shotaro Yamano, Kuniko Sunami, Takayuki Honda, Tomomi Nakahara, Tomoko Watanabe, Kae Okuma, Takafumi Kuroda, Takashi Kohno, Tomoyasu Kato, Kouya Shiraishi, Jun Itami
Format: article
Language:EN
Published: Nature Portfolio 2021
Subjects:
R
Q
Online Access:https://doaj.org/article/cda706406e7644d5a5156ae569f6d36b
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Summary:Abstract Somatic genetic alteration analysis was performed for post-hysterectomy high-risk early-stage uterine cervical cancer patients who underwent post-operative radiation therapy. Post-operative radiation therapy was performed for patients with pathological features of pelvic lymph node metastasis, parametrium invasion, or positive vaginal margin, which corresponded to the post-operative high-risk category. DNA was extracted from paraffin-embedded surgical specimens, and 50 somatic hotspot genetic alternations were detected using Ion AmpliSeq Cancer Hotspot Panel. The existence of actionable mutation was assessed based on OncoKB evidence level > 3A. Between January 2008 and November 2019, 89 patients who underwent abdominal radical hysterectomy followed by post-operative radiation therapy were identified. The follow-up period for living patients was 82.3 months (range 9.3–153.9), and the 5-year relapse-free survival and overall survival rates were 72.6% and 85.9%, respectively. The most frequently detected somatic mutation was PIK3CA (26 [29.2%] patients); however, no prognostic somatic genetic alterations were identified. Actionable mutations were detected in 30 (33.7%) patients. Actionable mutations were detected in approximately one-third of patients, suggesting that precision medicine can be offered to patients with post-operative high-risk uterine cervical cancer in the near future.