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| Nathaniel L. Jones, M.D., and Annelise M. Wilhite, M.D. |
Nathaniel L. Jones, M.D., gynecologic oncologist and assistant professor of gynecologic oncology at the USA College of Medicine, and Annelise M. Wilhite, M.D., a researcher and gynecologic oncology fellow at USA Health, were authors on four poster presentations related to uterine cancer.
For these research projects, Jones and Wilhite worked in collaboration with Caris Life Sciences and other members of the Precision Oncology Alliance, a working group of oncologists throughout the United States.
The University of South Alabama was the first institute in the country to be granted access to the Caris Code AI insurance claims data.
“It’s a very exciting opportunity for us,” Wilhite said. “This database includes molecular profiling on more than 200,000 tumors and allows researchers to evaluate the association between molecular profiles, treatment and outcomes on a large scale.”Jones said that much of their molecular profiling database research had been limited due to a lack of clinical correlates. “This database allows us to explore associations between molecular features of rare tumors, treatment modalities and survival, which we hope ultimately will translate to personalized treatment modalities and improved outcomes for our patients,” he said.
The poster presentations at ASCO included:
- “Molecular determinants of response to immune-oncology therapy in uterine carcinosarcoma”
Researchers sought to identify immunogenic markers in uterine carcinosarcoma (UCS), a subtype of endometrial cancer with an aggressive behavior and poor prognosis. They used next-generation DNA sequencing and explored treatment response to immune-oncology (IO) therapy.
The researchers concluded that microsatellite instability (MSI) and tumor mutational burden (TMB) are markers of improved overall survival in patients with uterine carcinosarcoma. MSI tumors have a distinct molecular profile compared with microsatellite stable (MSS) tumors, and they appear to be more immunogenic, which could contribute to improved survival in patients who received immune-oncology therapy.
- “Exploring molecular profiles of uterine carcinosarcoma with alterations in the chromatin remodeling pathway”
Researchers found that mutations in the KMT2C gene correlated with improved overall survival in uterine carcinosarcoma (USC) and that KMT2C-mutated tumors have distinct molecular profiles from wild type tumors, which suggests a potential role for immune-oncology therapy. This improved outcome remained true in a sub-analysis of microsatellite stable (MSS) tumors. More study on the impact of such therapy in the cohort is warranted, as this may contribute to the overall survival of these patients.
- “Association of the presence of estrogen and progesterone receptors in uterine carcinosarcoma with improved survival and increased immunogenicity”
Researchers found that expression of estrogen receptors (ER) and progesterone receptors (PR) in carcinosarcoma was associated with improved survival compared to ER- and PR-negative tumors. Because of this finding, they investigated molecular differences between tumors that had ER/PR expression and those that did not. Results demonstrated that hormone-receptor-positive tumors have many molecular differences compared with their hormone receptor negative counterparts.
The researchers concluded that hormone-receptor-positive tumors appear more immunogenic, suggesting a possible benefit with immune-oncology therapy. More data is needed to determine if hormone receptor status is a marker of a response to immune-oncology therapy.
- “Immune response markers and actual response to immune-oncology therapy in uterine serious sarcoma”
Researchers sought to characterize the immune profiles of uterine serous carcinoma, another very aggressive subtype of endometrial cancer, and investigate treatment response to immune-oncology therapy.
The researchers concluded that immune-oncology therapy was associated with a median survival benefit of more than two years in patients with uterine serous carcinoma. microsatellite instability (MSI) and tumor mutational burden (TMB) were low in serous tumors, but they found that the PD-L1 protein is present in nearly 20 percent of cases. Further study is warranted to determine whether they are predictors of a response to immune-oncology therapy.
