LAUSR

Cervical cancer, well known to be associated human papilloma virus Surgery in early stage cervical cancer is generally curative whereas the (HPV) infection and considered as a preventable cancer byHPV vaccination and organized screening for pre-cancerous lesions, continues to be an important cause of cancer relatedmortality especially in the developingworld [1].Majority of patients presentwith locally advanced disease when surgery is not feasible and concurrent chemoradiation therapy which consists of 45–50 Gy external-beam radiotherapy of the primary tumour with concomitant platinum-containing chemotherapy, followed by intracavitary brachytherapy is the standard of care [2]. The predominant radiation based treatment of cervical cancer makes extrapolation of in vitro laboratory studies using cell lines and animal models to the bedside very challenging unlike cancers which are predominantly treated by chemotherapy. Therefore, studies using patient tissue samples are particularly relevant. Cervical cancer has been impacted by the ‘omics’ revolution with many studies on gene expression profile and proteomic analysis reviewed by Lin et al. [3] These ‘big data’ technologies have been used to address the differences between cervical cancer vs normal cervix, Human Papilloma virus genomic integration and carcinogenesis and biomarkers of prognosis and prediction of response to radiation therapy [2]. The Cancer Genome Atlas (TCGA) and one previous publication addressed the genomic characterization of cervical cancer [4,5]. Notably, the specimen used in these studies were sourced from cervical cancers subjected to surgery, indicating that these represented early stage cervical cancers. In this issue of E-Biomedicine, Scholl et al. in their work titled “Clinical and genetic landscape of treatment naive cervical cancer: alterations in PIK3CA and in epigeneticmodulators associatedwith suboptimal outcome’ have evaluated the genetic landscape of cervical cancer by whole exome sequencing and next generation sequencing using patient tissue samples sourced from RAIDs (Rational Molecular Assessment and Innovative Drug Selection) network representing seven EU countries and 18 centers [6]. The merit of this study is in the fact that the samples of cervical cancer reflect the usual spread of cases across the FIGO (International Federation of Gynecology and Obstetrics) stages. Majority of patients included in the cohort underwent chemoradiation and their progression-free survival data using both the old and current versions of the FIGO classification was demonstrated [6].