Uterine cancer: DNA study could lead to targeted treatments
May 2, 2013 | by Nicole White
Though uterine cancer, also known as endometrial cancer, is the most common gynecologic cancer, in many ways scientists know very little about it – and doctors have few options for fighting it. A new report released Wednesday analyzing tumor DNA from hundreds of patients significantly pushes the frontiers of knowledge of this type of cancer, and provides a solid framework for developing personalized treatments.
The paper stems from the National Institutes of Health’s Cancer Genome Atlas Project, started in 2005 to catalogue genetic mutations responsible for cancer. The project has already yielded tumor genome information on breast, lung, colon, ovarian and brain cancers.
Thanh Dellinger, M.D., assistant professor in the Division of Gynecologic Oncology at City of Hope, said the study could open new doors for treatment, especially for patients whose endometrial cancer persists after surgery.
“For most uterine cancer patients, their cancer is treatable through a surgery – such as a hysterectomy – and that’s all the treatment they require,” said Dellinger, who was not involved in the study. “However, for those women whose cancer persists after surgery, we do not have any good options for them right now.”Endometrial cancer occurs in the lining of the uterus, and is the fourth most common malignancy in U.S. women, with an estimated 49,500 new cases and 8,200 deaths in 2013. The study, published in Nature , analyzed tumor DNA from 373 patients and compared it to DNA from healthy cells. The team was able to identify four new cancer subtypes based on different DNA mutations.
Dellinger, whose primary research interest is uterine cancer, said endometrial and other uterine cancers are understudied. Ovarian and cervical cancers, although often more severe, have a broader range of targeted-drug treatment options because the genetics of those diseases have been well-studied. Currently, women are diagnosed with uterine cancers based on clinical risk factors and pathology reports resulting from a biopsy.
“The prognostic model we’ve been using is relatively outdated,” she said. “We need to know more. We don’t have an optimal predictive model to determine who should receive chemotherapy, who should receive radiation, and who should receive some of the novel targeted therapies. This kind of molecular-based model may help with that.”
The study also uncovered some similarities between uterine cancers and breast and ovarian cancers that researchers will need to explore, as well as similarities among different types of endometrial cancers. The latter finding suggests that treatment options could be more similar than physicians have thought.