ArticleClinical cancer research : an official journal of the American Association for Cancer Research2024
Clinical and Genomic Landscape of RAS Mutations in Gynecologic Cancers.
Article in Clinical cancer research : an official journal of the American Association for Cancer Research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Spatial heterogeneity of hotspot mutations and clonal relatedness in ovarian endometrioid carcinoma.Molecular oncology · 2026Article
- Identification of candidate microRNA biomarkers of endometriosis in different bodily fluids.Scientific reports · 2026Article
- Autophagy modulation in gynaecologic oncology: insights into immune regulation and therapeutic potential.Frontiers in immunology · 2026Review
- Mesonephric-like Adenocarcinoma (MLA) Diagnostic Criteria and Controversies: Perspectives and Guidance From Pathologists in the MLA Consortium.International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists · 2026Review
- From Inflammation to Malignancy: The Link Between Endometriosis and Gynecological Cancers.International journal of molecular sciences · 2025Review
- Article
- Phosphocholine inhibits proliferation and reduces stemness of endometrial cancer cells by downregulating mTOR-c-Myc signaling.Cellular and molecular life sciences : CMLS · 2024Article
- Clinical and Genomic Landscape of RAS Mutations in Gynecologic Cancers.Clinical cancer research : an official journal of the American Association for Cancer Research · 2024Article
- Advances in research on malignant transformation of endometriosis-associated ovarian cancer.Frontiers in oncology · 2024Review
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Authors and funding
24 authors.
Funding
Abstract
purposeWe aimed to describe RAS mutations in gynecologic cancers as they relate to clinicopathologic and genomic features, survival, and therapeutic implications. EXPERIMENTAL
designGynecologic cancers with available somatic molecular profiling data at our institution between February 2010 and August 2022 were included and grouped by RAS mutation status. Overall survival was estimated by the Kaplan-Meier method, and multivariable analysis was performed using the Cox proportional hazard model.
resultsOf 3,328 gynecologic cancers, 523 (15.7%) showed any RAS mutation. Patients with RAS-mutated tumors were younger (57 vs. 60 years nonmutated), had a higher prevalence of endometriosis (27.3% vs. 16.9%), and lower grades (grade 1/2, 43.2% vs. 8.1%, all P < 0.0001). The highest prevalence of KRAS mutation was in mesonephric-like endometrial (100%, n = 9/9), mesonephric-like ovarian (83.3%, n = 5/6), mucinous ovarian (60.4%), and low-grade serous ovarian (44.4%) cancers. After adjustment for age, cancer type, and grade, RAS mutation was associated with worse overall survival [hazard ratio (HR) = 1.3; P = 0.001]. Specific mutations were in KRAS (13.5%), NRAS (2.0%), and HRAS (0.51%), most commonly KRAS G12D (28.4%) and G12V (26.1%). Common co-mutations were PIK3CA (30.9%), PTEN (28.8%), ARID1A (28.0%), and TP53 (27.9%), of which 64.7% were actionable. RAS + MAPK pathway-targeted therapies were administered to 62 patients with RAS-mutated cancers. While overall survival was significantly higher with therapy [8.4 years [(95% confidence interval (CI), 5.5-12.0) vs. 5.5 years (95% CI, 4.6-6.6); HR = 0.67; P = 0.031], this effect did not persist in multivariable analysis.
conclusionsRAS mutations in gynecologic cancers have a distinct histopathologic distribution and may impact overall survival. PIK3CA, PTEN, and ARID1A are potentially actionable co-alterations. RAS pathway-targeted therapy should be considered.
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