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Cervical cancer is down but not out. The cancer, which is caused by the sexually transmitted Human Papilloma Virus (HPV), is still diagnosed in some 12,000 women annually in the United States. But deaths from the disease — once the leading cancer killer of American women — plummeted by 70 percent between 1955 and 1992, the result of earlier diagnosis thanks largely to Pap smears, and the development in recent years of a preventive vaccine for certain types of HPV.
Still, in advanced cervical cancer that has recurred, treatment options remain limited. Using the powerful tools of genomic research, Alexi Wright, MD, a gynecologic oncologist in Dana-Farber's Susan F. Smith Center for Women's Cancers, has begun probing the relatively unknown cellular territory of cervical cancer, hunting for new opportunities to block the mutated gene pathways driving the cancer.
"We want to get a better understanding of the mutations, and find those that can be drugged. In the long term, we hope to help these women," says Dr. Wright, adding that many cervical cancer patients are only in their 30s and 40s.
Dr. Wright, with funding from the Friends of Dana-Farber Cancer Institute and a private donor, has launched a systematic search for cervical cancer mutations in stored patient tissue samples.
The study will make use of cervical cancer specimens from 100 consenting patients treated at Dana-Farber/Brigham and Women's Cancer Center (DF/BWCC) over the past decade. To sift the DNA of cancer cells for mutated oncogenes or tumor-suppressor genes, the scientists will use a system called OncoMap, developed by scientists in Dana-Farber's Center for Cancer Genome Discovery.
The OncoMap search will look for molecular opportunities such as cell-cycle and cell-growth regulators that behave differently in the cancer cells. The scientists will then determine which are potentially responsive to drugs, leading to clinical trials of specifically targeted agents. Ursula Matulonis, MD, medical director of gynecologic oncology at the Susan F. Smith Center for Women's Cancers, and Michelle Hirsch, MD, PhD, genitourinary pathologist at Brigham and Women's Hospital, will provide additional expertise and mentorship.
Turning Point 2011