PIK3CA mutations and their impact on survival outcomes of patients with endometrial cancer: A systematic review and meta-analysis

Hanna K Bredin; Camilla Krakstad; Erling A Hoivik

doi:10.1371/journal.pone.0283203

PIK3CA mutations and their impact on survival outcomes of patients with endometrial cancer: A systematic review and meta-analysis

PLoS One. 2023 Mar 21;18(3):e0283203. doi: 10.1371/journal.pone.0283203. eCollection 2023.

Authors

Hanna K Bredin^{1

2}, Camilla Krakstad^{1

2}, Erling A Hoivik^{1

2}

Affiliations

¹ Department of Clinical Science, Centre for Cancer Biomarkers, University of Bergen, Bergen, Norway.
² Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway.

Abstract

Several studies have highlighted the frequent alterations of the PI3K pathway in endometrial cancer leading to increased signaling activation with potential for targeted treatment. The objective of this meta-study was to evaluate how PIK3CA exon 9/20 mutations affect survival in endometrial cancer patients, based on available literature. Topic-based search strategies were applied to databases including CENTRAL, MEDLINE, Embase, Web of Science and COSMIC. All studies assessing the impact of mutations in exon 9 and exon 20 of PIK3CA on survival rates of endometrial cancer patients were selected for inclusion. Statistical meta-analysis was performed with the 'meta' package in RStudio. Overall, 7 of 612 screened articles were included in the present study, comprising 1098 women with endometrial cancer. Meta-analysis revealed a tendency of impaired survival for patients with PIK3CA exon 9 and/or exon 20 mutations (RR 1.28; 95% CI 0.84, 1.94; p = 0.25). This tendency was consistent in subgroup analyses stratified by histologic type or -grade, with the most prominent effect in low-grade endometrial cancers (RR 2.04; 95% CI 0.90, 4.62; p = 0.09). In summary, these results suggest that PIK3CA mutations negatively influence survival outcomes of patients with endometrial cancer, including those with low-grade tumors.

Copyright: © 2023 Bredin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Meta-Analysis
Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Class I Phosphatidylinositol 3-Kinases / genetics
Class I Phosphatidylinositol 3-Kinases / metabolism
Endometrial Neoplasms* / pathology
Female
Humans
Mutation
Phosphatidylinositol 3-Kinases* / genetics
Phosphatidylinositol 3-Kinases* / metabolism
Signal Transduction

Substances

Phosphatidylinositol 3-Kinases
Class I Phosphatidylinositol 3-Kinases
PIK3CA protein, human

Grants and funding

Initials of the authors who received each award: CK Grant numbers awarded to each author: The Norwegian Cancer Society (190202), Norwegian Research Council (273280) The full name of each funder: The Norwegian Cancer Society, Norwegian Research Council, The University of Bergen URL of each funder website: https://kreftforeningen.no/en/https://www.forskningsradet.no/en/https://www.uib.no/en Did the sponsors or funders play any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript? The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.