Molecular Markers to Predict Prognosis and Treatment Response in Uterine Cervical Cancer

Abstract

Uterine cervical cancer is one of the leading causes of cancer-related mortality in women worldwide. Each year, over half a million new cases are estimated, resulting in more than 300,000 deaths. While less-invasive, fertility-preserving surgical procedures can be offered to women in early stages, treatment for locally advanced disease may include radical hysterectomy, primary chemoradiotherapy (CRT) or a combination of these modalities. Concurrent platinum-based chemoradiotherapy regimens remain the first-line treatments for locally advanced cervical cancer. Despite achievements such as the introduction of angiogenesis inhibitors, and more recently immunotherapies, the overall survival of women with persistent, recurrent or metastatic disease has not been extended significantly in the last decades. Furthermore, a broad spectrum of molecular markers to predict therapy response and survival and to identify patients with high- and low-risk constellations is missing. Implementation of these markers, however, may help to further improve treatment and to develop new targeted therapies. This review aims to provide comprehensive insights into the complex mechanisms of cervical cancer pathogenesis within the context of molecular markers for predicting treatment response and prognosis.

HPV-Positive and -Negative Cervical Cancers Are Immunologically Distinct

“…While the HPV genome is maintained episomally in a normal infection, integration into the host cell genome is a frequent event in CC [ 7 ]. The impact of integration of the viral genome on CC prognosis has been suggested to be negatively correlated with patient outcomes [ 41 ], although recent data do not fully support this conclusion [ 42 ]. We directly compared all the immune related parameters from this study between HPV α9-positive CC with integrated viral genomes and HPV α9-positive CC with non-integrated viral genomes.…”

The impact of para-aortic lymph node irradiation on disease-free survival in patients with cervical cancer: A systematic review and meta-analysis

“…Patient selection for PAO-RT may be improved by recently developed nomograms that predict PAO nodal failure [57] , [58] . In addition, ongoing research is exploring if the prediction accuracy of such nomograms could be improved by studying molecular tumor profiles or extracting imaging features with radiomics or deep learning techniques [59] , [60] , [61] .…”

SPI1‐related protein inhibits cervical cancer cell progression and prevents macrophage cell migration

“…14 More than 500 000 new CC cases and 300 000 CC-related deaths occur per year globally. 15,16 Chemoradiation and surgical resection are the standard therapeutic strategies for CC. 17 However, these therapeutic options only can improve the overall survival of CC patients and CC patients with recurrent or metastatic diseases cannot be cured through the abovementioned approaches.…”

“…CC is a major threat to the health of women with the fourth incidence and mortality rates in all cancers globally 14 . More than 500 000 new CC cases and 300 000 CC‐related deaths occur per year globally 15,16 . Chemoradiation and surgical resection are the standard therapeutic strategies for CC 17 .…”