TY - JOUR
T1 - Clinical outcomes and differential effects of PI3K pathway mutation in obese versus non-obese patients with cervical cancer
AU - Grigsby, Perry
AU - Elhammali, Adnan
AU - Ruiz, Fiona
AU - Markovina, Stephanie
AU - McLellan, Michael D.
AU - Miller, Christopher A.
AU - Chundury, Anupama
AU - Ta, Ngoc Anh L.
AU - Rashmi, Ramachandran
AU - Pfeifer, John D.
AU - Fulton, Robert S.
AU - DeWees, Todd
AU - Schwarz, Julie K.
N1 - Publisher Copyright:
© Grigsby et al.
PY - 2018
Y1 - 2018
N2 - The purpose of this study was to evaluate the effect of obesity and obesityassociated factors on the outcomes of patients with cervical cancer. Outcomes were evaluated in 591 patients with FIGO Ib to IV cervical cancer treated uniformly with definitive radiation. Patients were stratified into 3 groups based upon pretreatment Body Mass Index (BMI): A ≤ 18.5; B 18.6 - 34.9; and C ≥ 35. The 5-year freedom from failure rates were 58, 59, and 73% for BMI groups A, B, and C (p = 0.01). Overall survival rates were 50, 59, and 68%, respectively (p = 0.02). High expression of phosphorylated AKT (pAKT) was associated with poor outcomes only in non-obese patients. Obese patients with PI3K pathway mutant tumors had a trend toward favorable outcomes, while a similar effect was not observed in non-obese patients. Compared to similar tumors from non-obese hosts, PIK3CA and PTEN mutant tumors from obese patients failed to express high levels of phosphorylated AKT and its downstream targets. These results show that patients with obesity at the time of diagnosis of cervical cancer exhibit improved outcomes after radiation. PI3K/AKT pathway mutations are common in obese patients, but are not associated with activation of AKT signaling.
AB - The purpose of this study was to evaluate the effect of obesity and obesityassociated factors on the outcomes of patients with cervical cancer. Outcomes were evaluated in 591 patients with FIGO Ib to IV cervical cancer treated uniformly with definitive radiation. Patients were stratified into 3 groups based upon pretreatment Body Mass Index (BMI): A ≤ 18.5; B 18.6 - 34.9; and C ≥ 35. The 5-year freedom from failure rates were 58, 59, and 73% for BMI groups A, B, and C (p = 0.01). Overall survival rates were 50, 59, and 68%, respectively (p = 0.02). High expression of phosphorylated AKT (pAKT) was associated with poor outcomes only in non-obese patients. Obese patients with PI3K pathway mutant tumors had a trend toward favorable outcomes, while a similar effect was not observed in non-obese patients. Compared to similar tumors from non-obese hosts, PIK3CA and PTEN mutant tumors from obese patients failed to express high levels of phosphorylated AKT and its downstream targets. These results show that patients with obesity at the time of diagnosis of cervical cancer exhibit improved outcomes after radiation. PI3K/AKT pathway mutations are common in obese patients, but are not associated with activation of AKT signaling.
KW - Cervical cancer
KW - Mutation
KW - Obesity
KW - PI3K
KW - PTEN
UR - http://www.scopus.com/inward/record.url?scp=85040165139&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85040165139&partnerID=8YFLogxK
U2 - 10.18632/oncotarget.23664
DO - 10.18632/oncotarget.23664
M3 - Article
C2 - 29423104
AN - SCOPUS:85040165139
SN - 1949-2553
VL - 9
SP - 4061
EP - 4073
JO - Oncotarget
JF - Oncotarget
IS - 3
ER -