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

Murakami, Naoya; Asami, Yuka; Yoshida, Hiroshi; Takayanagi, Daisuke; Hirose, Sou; Kuno, Ikumi; Takahashi, Kazuaki; Matsuda, Maiko; Shimada, Yoko; Yamano, Shotaro; Sunami, Kuniko; Honda, Takayuki; Nakahara, Tomomi; Watanabe, Tomoko; Okuma, Kae; Kuroda, Takafumi; Kohno, Takashi; Kato, Tomoyasu; Shiraishi, Kouya; Itami, Jun

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.

CERVICAL cancer patients; RADIOTHERAPY; LYMPH node cancer; HYSTERECTOMY; NUCLEIC acid isolation methods

Scientific Reports, 2021, Vol 11, Issue 1, p1

2045-2322

Academic Journal

10.1038/s41598-021-90139-0