Signature, please

AUGUSTA, Ga.—Women who don’t survive a rare and aggressive uterine cancer called uterine serous carcinoma (USC) have high expression of a group of 73 genes, which scientists say could help identify these women and improve their outcome.

“It is a very aggressive cancer,” said Lynn Tran, an M.D./Ph.D. student at the Medical College of Georgia at Augusta University and first author of the study into this genetic signature, which was published in the spring in the journal Gynecologic Oncology.

More than half of women with USC have more advanced Stage III or IV disease at diagnosis and about half the patients who have it die and die very quickly,” Tran says. “The question was, can you tell who those half are?”

Tran and the rest of the research team found that women with high USC73 scores had the worst prognosis, the highest cancer cell proliferation and progression rates and the lowest rates of complete response to standard therapy.

Their findings suggest the USC73 score is a biomarker for both the identification of women who will not respond to standard therapy and for efficient clinical trials to find drugs that do work, according to Dr. Jin-Xiong She, director of the MCG Center for Biotechnology and Genomic Medicine, Georgia Research Alliance Eminent Scholar in Genomic Medicine and the study’s corresponding author.

Many of these 73 genes have functions important to cancer, like cell survival and migration. When they looked in detail at the cancer cell lines of patients with high expression of what they now call USC73, they found increased cell cycle progression and growth consistent with poor patient survival.

They don’t know yet whether high USC73 is causative of the more aggressive version of this uterine cancer or just associated with it, but are continuing to pursue those answers.

“The difference in survival may be caused by something that we are not measuring, it just may be correlated to the things we are measuring,” Tran says.