Zibi Marchocki1, Brenna Swift1, Allan Covens2. 1. Division of Gynecologic Oncology, University of Toronto, Toronto, ON, Canada. 2. Division of Gynecologic Oncology, Sunnybrook, Health Sciences Centre, Odette Cancer Centre, Toronto, ON, Canada. al.covens@sunnybrook.ca.
Abstract
PURPOSE OF REVIEW: The goal of this paper was to summarize the recent evidence on rare subtypes of cervical cancer including small-cell carcinoma of the cervix (SCCC), gastric-type adenocarcinoma, and carcinosarcoma. RECENT FINDINGS: All three cervical cancer subtypes are aggressive with poor treatment response and high recurrence rates. Molecular studies have identified various actionable mutations in both SCCC (PIK3CA, MYC, TP53, PTEN, ARID1A, KRAS, BRCA2) and gastric-type adenocarcinoma (KRAS, ARID1A, PTEN). While there are a limited number of case reports demonstrating a favorable response for recurrent SCCC to immune checkpoint inhibitors, a larger case series failed to show benefit. The checkpoint inhibitors role in gastric-type adenocarcinoma and carcinosarcoma is yet to be determined. Ninety-one percent of SCCC cases show PARP expression, suggesting a possible role for PARP inhibitors; however, this has yet to be examined in future clinical trials. More studies are needed, with a focus on targeted therapies. The role of PARP inhibitors in SCCC is potentially promising, but significant collaboration between centers/groups will be required to achieve this.
PURPOSE OF REVIEW: The goal of this paper was to summarize the recent evidence on rare subtypes of cervical cancer including small-cell carcinoma of the cervix (SCCC), gastric-type adenocarcinoma, and carcinosarcoma. RECENT FINDINGS: All three cervical cancer subtypes are aggressive with poor treatment response and high recurrence rates. Molecular studies have identified various actionable mutations in both SCCC (PIK3CA, MYC, TP53, PTEN, ARID1A, KRAS, BRCA2) and gastric-type adenocarcinoma (KRAS, ARID1A, PTEN). While there are a limited number of case reports demonstrating a favorable response for recurrent SCCC to immune checkpoint inhibitors, a larger case series failed to show benefit. The checkpoint inhibitors role in gastric-type adenocarcinoma and carcinosarcoma is yet to be determined. Ninety-one percent of SCCC cases show PARP expression, suggesting a possible role for PARP inhibitors; however, this has yet to be examined in future clinical trials. More studies are needed, with a focus on targeted therapies. The role of PARP inhibitors in SCCC is potentially promising, but significant collaboration between centers/groups will be required to achieve this.
Authors: Toyomi Satoh; Yuji Takei; Isabelle Treilleux; Mojgan Devouassoux-Shisheboran; Jonathan Ledermann; Akila N Viswanathan; Sven Mahner; Diane M Provencher; Linda Mileshkin; Elizabeth Åvall-Lundqvist; Patricia Pautier; Nicholas Simon Reed; Keiichi Fujiwara Journal: Int J Gynecol Cancer Date: 2014-11 Impact factor: 3.437
Authors: Benjamin Margolis; Ana I Tergas; Ling Chen; June Y Hou; William M Burke; Jim C Hu; Cande V Ananth; Alfred I Neugut; Dawn L Hershman; Jason D Wright Journal: Gynecol Oncol Date: 2016-02-09 Impact factor: 5.482
Authors: I I Wistuba; B Thomas; C Behrens; N Onuki; G Lindberg; J Albores-Saavedra; A F Gazdar Journal: Gynecol Oncol Date: 1999-01 Impact factor: 5.482
Authors: J R van Nagell; D E Powell; H H Gallion; D G Elliott; E S Donaldson; A E Carpenter; R V Higgins; R Kryscio; E J Pavlik Journal: Cancer Date: 1988-10-15 Impact factor: 6.860