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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Gynecological Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1445128

Race-associated molecular differences in uterine serous carcinoma

Provisionally accepted
Olivia Lara Olivia Lara 1Hannah Karpal Hannah Karpal 2*Steven Friedman Steven Friedman 2*Kari Hacker Kari Hacker 2*Bhavana Pothuri Bhavana Pothuri 2*
  • 1 University of North Carolina Hospitals, Chapel Hill, United States
  • 2 Langone Medical Center, New York University, New York City, New York, United States

The final, formatted version of the article will be published soon.

    Purpose: Endometrial cancer (EMCA) is the most common gynecologic malignancy and new diagnoses are increasing in the United States. Black patients are more likely to present with advanced stage, be diagnosed with high-risk uterine serous carcinoma (USC) and die of their cancer. Methods: Patients with endometrial adenocarcinoma who received tumor FoundationOne CDx testing at our institution between January 2017 and August 2022 were identified. Genomic alterations, demographic and clinical characteristics were collected. Descriptive statistics and Fisher's exact test were used to analyze data. Results: A total of 289 patients (29.4% Black and 52.6% White) with advanced or recurrent endometrial adenocarcinoma underwent FoundationOne Cdx testing. USC comprised 26.3 % (76 of 289) of tested tumors. Of USC tumors 33 of 76 (44%) were of Black race. USC occurred more frequently in Black patients (33 of 85 [38.8%] Black patients compared to 30 of 152 [19.7%] White patients, p<0.05). Among USC, CCNE1 amplification occurred more frequently in Black patients than in White patients (12 of 33 [36.36%] vs 2 of 30 [6.67%], p<0.05) while PI3K/AKT/mTOR pathway mutations occurred less frequently (16 of 33 [48.5%] vs 26 of 33 [86.7%], p=0.17). Among patients with CCNE1 amplification 73.3% (11 of 15)progressed on or within 12 months of first-line platinum-based therapy. CCNE1 amplification had significantly shorter median overall survival (97.3 months vs 44.3; HR (95%CI): 7.1 (10.03, 59.4) p< 0.05).Conclusions: Black patients constituted 44% patients with USC in our study and had an increased frequency of CCNE1 amplification. Patients whose tumors harbored CCNE1 amplification had shorter overall survival. Identifying actionable mutations in this high unmet need population is crucial to improving outcomes among Black patients with uterine malignancy. Development of new targetedtherapies will need to keep these alterations at the forefront as trials are being designed.

    Keywords: Uterine Cancer, Health Disparities, race, gynecologic cancer, Targeted treatement

    Received: 06 Jun 2024; Accepted: 02 Sep 2024.

    Copyright: © 2024 Lara, Karpal, Friedman, Hacker and Pothuri. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Hannah Karpal, Langone Medical Center, New York University, New York City, 10016, New York, United States
    Steven Friedman, Langone Medical Center, New York University, New York City, 10016, New York, United States
    Kari Hacker, Langone Medical Center, New York University, New York City, 10016, New York, United States
    Bhavana Pothuri, Langone Medical Center, New York University, New York City, 10016, New York, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.