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Molecular pathology of uterine sarcoma
Recent research has improved our understanding of how changes
in certain molecules can cause normal cells to become cancerous. For
several years we have known that mutations (damage or defects) to DNA
can alter important genes that regulate cell growth. If these genes are
damaged, excess growth may result in cancer formation. Analysis of DNA
from uterine sarcomas has revealed several changes in the genes that
control cell growth. Each human cell contains 23 pairs of chromosomes.
In most endometrial stromal sarcomas (especially low grade ones), there
is an abnormal "swapping" of chromosomal material
(DNA) between chromosomes 7 and 17. Part of chromosome 7 goes to 17 and
part of 17 goes to 7. This is known as a translocation. The
swapping of DNA between the chromosomes leads to the formation of a new
gene, called JAZF1/JJAZ1,
which causes the cells to become malignant.
Scientists expect that these discoveries such as this will
eventually lead to new strategies for detection, prevention, and
treatment.
Clinical trials
New drugs, as well as new ways to give standard drugs are
being tested. One drug under study, trabectedin (Yondelis®)
has
had some promising results in early trials of patients with sarcoma.
Another drug, temozolomide, which is approved to treat brain tumors,
also seems to help patients with sarcoma. Adjuvant radiation and
chemotherapy continue to be evaluated for treatment of uterine
sarcomas. New compounds are also being evaluated in soft-tissue
sarcomas. Some of these compounds act differently from traditional
chemotherapy drugs and are called targeted therapies.
Last Medical Review: 11/18/2009 Last Revised: 11/18/2009
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