Study: Type of Cervical Cancer May Drive Treatment Choice

By Alexi Wright, MD, MPH

Although there are two main types of cervical cancer, known as adenocarcinoma and squamous cell carcinoma, they’ve generally been treated as one disease, with the same approach to treatment. In a recent study, my colleagues and I surveyed the DNA in both types of cervical cancer cells to see if there were any differences. Such variations may help explain why the two types sometimes behave the way they do, and guide us toward treatments that work best in one type or the other.

Alexi Wright, MD, MPH

Our study, which was published in the journal Cancer, was the first to compare the spectrum of cancer-related gene mutations in these two varieties of cervical cancer. In tests on 80 cervical tumor samples, we found high rates of mutations in two genes: PIK3CA and KRAS. Although PIK3CA mutations appeared in both subtypes, KRAS mutations were found only in adenocarcinomas.

By linking our findings to data on patients’ treatment and survival, we found that patients whose tumors carried a PIK3CA mutation generally didn’t survive as long as patients whose tumors lacked that mutation.

The discovery of high rates of PIK3CA mutations in the cervical tumor samples suggests that many patients could benefit from drugs known as PI3-kinase inhibitors, which target the family of proteins associated with the gene. Patients with the adenocarcinoma subtype of cervical cancer may benefit from targeted agents known as MEK inhibitors, which have shown some success in clinical trials.

Our findings are an important step toward treatments that take aim at the specific genetic malfunctions in these two tumor types. By being more specific, such treatments may also be more effective.